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(615) 398-4808
info@qgdispatch.com
DISPATCH SETUP
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Setup
Carrier Name
MC #
DOT #
Carrier Contact Name
Carrier Phone
Carrier Email
Street Address
City
State
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Country
Country
United States
Company Type
Company Type
LLC
INC
Sole proprietorship
Partnership
Tax ID
Will you be using Factoring Company?
Yes
No
Factoring Company Name
Factoring Company Address
Number of Trucks
1
2
3
4
5 or more
Equipment Type
Dry Van
Reefer
Flatbed
Hot-Shot
Car Hauler
Stright Truck
Please describe any additional equipment you might have
Max net cargo weight
Please upload following documents:
Copy of MC Authority certificate
Copy of your Insurance binder (Acord format)
W-9 Form
Your MC Authority Certificate
Your Insurance Binder (Acord format)
Your W-9 Form
Who will be driving your truck?
Driver's Phone Number
Driver's Email
Truck Number
Trailer Number
Submit Form
