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DAWG BONE LOGISTICS

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Thank you for choosing DAWG BONE LOGISTICS. Please fill out the following information to the best of your ability. If the question does not apply to you please answer "N/A" in the blank space.

FULL NAME*

DATE*

COMPANY NAME OR DBA*

PHONE #*

EMAIL ADDRESS*

PREFERRED METHOD OF CONTACT*

PHONE

EMAIL

MC#*

DOT#*

WHAT TYPE OF TRAILER(S) DO YOU HAVE? (include dimensions & equipment you have)*

HOW MANY TRUCKS DO YOU HAVE?*

DO YOU HAVE A FACTORING COMPANY?*

YES

NO

IF "NO", HOW DO YOU INDEND TO GET PAID?

FACTORING COMPANY NAME*

FACTORING COMPANY PHONE #*

DRIVER(S) NAME(S)*

PREFERRED GEOGRAPHICAL LANES*

SOUTHERN STATES

WEST COAST STATES

MIDWEST STATES

SOUTHEASTERN STATES

NORTHEASTERN STATES

ZONES TO AVOID*

ZONE 0

ZONE 1

ZONE 2

ZONE 3

ZONE 4

ZONE 5

ZONE 6

ZONE 7

ZONE 8

ZONE 9

LIST ANY PREFERRED LANE DETAILS*

BREAK EVEN POINT*

MAX LOAD CAPACITY*

EMAIL ADDRESS TO RECEIVE INVOICES FROM DAWG BONE LOGISTICS*

INSURANCE COMPANY NAME (Copy of Original Certificate will be requested)*

AGENT AND CONTACT INFORMATION*

STARTING LOCATION*

HOW LONG HAVE YOU HAD YOUR AUTHORITY?*

DAWG BONE LOGISTICS

DAWGBONELOGISTICS@GMAIL.COM

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