Become an Authorized Carrier for BTSI
Attention All Carriers
Below are the standardized requirements to become an Authorized Carrier for Bowyer Transportation Services, Inc.:
Certificate of Insurance
The original certificate with Bowyer Transportation Services, Inc., as Certificate Holder and Named Additional Insured with no less than 30 days notice of cancellation. Your insurance carrier must send the certificate.
Minimum liBTSIlity coverage of $1,000,000.00
Minimum amount of cargo coverage of $250,000.00
Copy of current FHA Authority Certificate or appropriate State registration.
W-9 completed and returned. IRS regulation requires backup withholding of 30% of payment if W-9 is not on file.
Certificate of ICC Contract Carrier Operating Authority.
Federal ID Number
Signed Broker/Carrier Contract. Entire contract must be returned to us. (PAYMENT WILL BE WITHHELD UNTIL CONTRACT IS IN EFFECT).
Pam Warren
Vice President
Complete and fax to 660-548-3006 the following application, along with the above named documents for consideration for becoming an Authorized Carrier for BTSI.
Pam Warren
Vice President
Authorized Carrier Application
Company Name________________________________ Contact ____________________________
Business Address_______________________________ City/State/Zip ________________________
Phone _______________________________________ Fax ________________________________
Toll Free ____________________________________ Email _______________________________
Cell Phone ____________________________________ Pager ______________________________
[ ] Individual [ ] Corporation State of Incorporation _______________________________
If Corporation, please state Principals and Officers _________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
ICC Authority Number ______________________________________________________
Federal Identification Number_________________________________________________
Years in Business operating under current name__________________________________
If less than 1 (one) year of business give previous name ____________________________
____________________________________________________________________________
List 3 (three) business references
Name/Address/Phone
1.______________________________________________________________________________
2.______________________________________________________________________________
3.______________________________________________________________________________
Normal traffic lanes or geographic areas primarily served __________________________________
________________________________________________________________________________
________________________________________________________________________________
Does your company trip lease or broker loads to outside carriers? [ ] Yes [ ] No
The above information is accurate and verifiable.
Signature ________________________________________________ Date ___________________
Printed Name/Title _________________________________________________________________
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