JOHN J JERUE TRUCK BROKER INC

Reliable & Efficient Logistics Solutions tailored to your business needs.

MC-265774 | USDOT 2216237 | 3200 FLIGHTLINE DRIVE, SUITE 202, LAKELAND, FL 33811

CARRIER SETUP PACKET

Company

Equip & Driver

Insurance

Payment

Documents

Signature

Company Legal Name *

DBA (if applicable)

MC Number *

DOT Number *

EIN / Tax ID *

Physical Address *

Mailing Address

Primary Contact Name *

Title *

Phone *

Email *

Truck Type *

# Power Units *

Unit Number / Plate

VIN

Trailer Type & ID

Driver Name *

CDL # *

CDL State *

Driver Phone *

Driver Email

Authorized Signatory Name *

Title *

Insurance Carrier *

Policy Number *

Effective Date *

Expiration Date *

Limits (Auto/Gen/Cargo) *

Payment Method *

Factoring Quick Pay ACH/Direct Deposit Standard Pay

Upload required documents (W9, Insurance Certificate, MC authority, Carrier Agreement, CDL, etc.)

W9 Document

Insurance COI

MC Authority

Carrier Agreement

CDL Copy

BOC-3 (opt)