Welcome Brokers to your Free Access Auto Load Board! Please read and understand the User Agreement form before submitting your request. Upon posting any individual cars, partial loads or full loads; you must be approved. Any loads posted without permission will be deleted and your load will not be moved. Fax the form below to ( 305 ) 513-5115.
USER AGREEMENT FORM
BROKERs ONLY
Please read the following user agreement before REQUESTING TO POST your load. Upon posting any individual cars, partial loads or full loads; please fill out the following form and fax back to 305-513-5115 for permission to use this site.
Vendor Type: Broker
Requestor Name: __________________________
Requestor Email: ________________
Broker Name: ____________________________________________________________
Broker Address: __________________________________________________________
Phone #: ( ) _____________________
Fax: ( ) _____________________________
Cell: ( ) ______________________
Cell #2 ( ) _______________________________
Broker Tax Payer FEIN# ______________________ W-9 Form: ___
Broker Authority /BC# _____________________
Dealer License# _______________
Insurance Bond: __________________________________________________________
ON A SEPARATE SHEET OF PAPER FAX 5 REFERENCES
( name / companies, address, phone ) references will be called upon permission to post.
Signature: ___________________________
Print: _________________________
Date of Agreement :___________________
Witness: _______________________
Office use only:
References Checked: _____
Authority Status Checked: ______
Insurance Status Checked: ______