Carrier Name:

ABC Logistics

Address:

123 Main Street

City:

Chicago

State:

Illinois

Zip Code:

60605

MC#:

123456

DOT#:

1234

STDOT#:

12345

Contract:

Track Via:

Owner Operator Qty:

5

Private Fleet:

Minority Owned:

Cargo Insurance #:

135456

Cargo Ins. Exp. Date:

Liability Insurance #:

135456

Liability Ins. Exp. Date:

Hazmat Certified:

Liquor License:

Name:

Ash Ketchum

Check Name:

Ash Ketchum

Address:

135 Pikachu Lane

Address, continued:

n/a

City:

Chicago

State:

Illinois

Payment Type:

ACH Enabled:

Bank Name:

Chase

Full Bank Address:

345 Gold Blvd, Chicago, IL, 890765