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Disptach Management Services

Employees need to realize the importance of working well with their teammates.

    110 2ND ST SW STE 100 AUBURN, WA 98001

    Phone: 8005773940


    Carrier/Company Profile Form

    Instructions: Please complete this form, giving us all the information that pertains to you and your company. The better informed we are, the better we will be able to assist you.

    This form can be updated at anytime by notifying us. This information is for our use only and will not be released to any third party.

    Part1: Carrier Profile Information Section

    First name

    Company Name & DBA

    Street Address
    Postal / Zip Code

    Office Phone Number

    Area Code

    Emergency Phone Number

    Area Code

    Sales Rep at Disptach Management Services *

    Sales rep other then above
    Who referred you


    How many trucks do you have?*

    How many trailers do you have?*

    How many trucks are you assigning us to dispatch*

    Type of trailer*

    Please give us your minimum rate information. We understand that many factors will change this information but this will give us a starting point.

    Minimum rate per mile*

    Comments if any

    If you use a factoring service, please provide us the following information. This will ensure that we only use brokers or shippers that are approved by your factoring company.

    Factoring Company Name

    Insurance company Phone Number

    Area Code


    Complete signed W9 form attach here

    Take a picture of motor carrier certificate above or attach here

    Take a photo certificate of insurance above or attach here

    Dispatcher – Carrier Agreement. This agreement is prepared on

    This date of*

    By and Between Carrier Name *

    Dispatch service provider is a transportation dispatcher handling the necessary paperwork between BROKERS/SHIPPERS and the CARRIERS in order to secure “CARGO” for said CARRIER/INDEPENDENT OWNER OPERATOR. WHEREAS, CARRIER is a Motor CONTRACT Carrier subject to the jurisdiction of the ICC: NOW, THEREFORE, inconsideration of the promises and convents hereinafter contained, it is mutually agreed by and between parties hereto as


    1. DISPATCHER agrees to handle, phone; fax calls to, from the BROKER or SHIPPER to tender commodities shipments to CARRIER for transportation in interstate commerce by CARRIER between points and places within the scope of CARRIER’S OWN operating authority.

    2. DISPATCHER bears no financial or legal responsibility in the transaction between the SHIPPER, CARRIER or INSURANCE

    3. DISPATCHER will:

    a. Make 100% effort to keep truck(s) loaded.

    b. CARRIER will be contacted about EVERY load we find to offer, and the driver/owner will ACCEPT or REJECT the load at sole decision and will be no force dispatched.

    c. Invoice the CARRIER at time of service; also provide a copy of each Load Confirmation number CARRIER is being
    billed for.

    Carrier agrees that all the trucks & owner operators provided to the carrier by the dispatcher will always be paid to
    dispatcher at $54.98 for every load dispatched by Transport Logistic Management.


    1. Flat fee of $54.98 will be charged for every load.

    2. CARRIER gives DISPATCHER authority to provide his/her signature for rate confirmation sheets. Carrier also bares all

    responsibility to the ICC, FMCSA DOT compliance and dispatcher or dispatch service provider will be held harmless in any incidents or circumstances. Carrier also certifies the trucks and trailer provided to Disptach Management Services by the carrier are either owned or leased and are 100% compliant to run under carriers authority.

    3. BROKER/SHIPPER agrees to pay CARRIER promptly, following receipt of a freight bill and proof of delivery of each shipment to its assigned destination, free of damage or shortage. The amount to be paid by SHIPPER to CARRIER shall be established between parties on a per shipment basis prior to commencement of each individual shipment. A load confirmation including details of shipment and revenue to be paid, will be supplied via FAX or EMAIL by BROKER/DISPATCHER/SHIPPER to CARRIER. Confirmation will be signed by DISPATCHER and returned via EMAIL to SHIPPER.

    Payments are due to the DISPATCHER for services rendered and payments that are due to the DISPATCHER for services rendered are not contingent on outstanding company payments due to the CARRIER for loads the he/she has hauled for the SHIPPER OR BROKER.

    Failure to pay the DISPATCHER for services rendered will result in termination of contract and services immediately unless otherwise determined by the DISPATCHER and dispatching company will then proceed the balance due to a third party collection company to collect from the carrier.

    This contract can be terminated at any time once the dues are fully paid by the Carrier.

    First Name

    Last Name

    Title *

    Official Disclosure Statement:

    I certify that I personally completed this application and that all of the information is true and correct to the best of my knowledge.

    I also understand and certify that this application is submitted to a Dispatching service provider and not a broker or shipper.

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