MetroGistics Carrier Agreement

Please fill out the following form, read the agreement, and sign below. Or click here for the mobile version of the Carrier Agreement.

Carrier Operation*:

Company Name*:
D/B/A Name:
Address 1*:
Address 2:
City*:
State or Province*:
Zip Or Postal Code*:
Carrier ICC MC#*:

Carrier DOT#*:
FED ID#*:
Contact First Name*:
Contact Last Name*:
Title:
Phone*:
Cell Phone*:
After Hours Contact*:

Fax*:
Email*:
Verify Email*:
How do you want your orders sent to you*: Fax
Email
Do You Have Strap Capabilities?*: Yes
No
Can you operate in all 48 states?: Yes
No
What are your strongest running lanes?:
Number of Trucks:

What Equipment Type Do You Operate?:

1 Car Haulers: Yes No

How Many?:

2-5 Car Haulers: Yes No

How Many?:

6-9 Car Haulers: Yes No

How Many?:

10+ Car Haulers: Yes No

How Many?:

Agreement:
Do you accept the agreement above?*
Yes, I accept this agreement.
No, I reject this agreement.

Payment Method*: ComCheck Pay Option - 2 Day Pay: 10% Surcharge
Power Pay Option - 2 Day Pay: 10% Surcharge
Fast Pay Option - Weekly Pay: 7.5% Surcharge
Regular Pay Option - Net 30 days of Receipt of BOL and Invoice
**Payment will only be authorized with clean signed delivery paperwork, failure to obtain signatures upon delivery will delay payment, WE NEED BOTH THE SIGNED BOL AND INVOICE BEFORE PAYMENT WILL MADE**

Do you use a factoring company?* Yes
No

Factoring Company Name*:
Factoring Company Complete Address*:
Factoring Company Phone Number*:
Factoring Contact Name*:

By typing your full name in the following form field, you accept the agreement above in full as well as assure that all information you've entered is valid.