Florilli Logisitics, LLC

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Carrier Profile Entry

IN ORDER TO BE QUALIFIED AS A CARRIER FOR FLORILLI LOGISTICS, LLC THE FOLLOWING INFORMATION IS REQUIRED FOR OUR FILES:

• Copy of Operating Authority
• Certificate of Insurance naming Florilli Logistics, LLC as holder for both Cargo and Liability.
• Completed W-9
• Signed Broker/Carrier Agreement

Please fax, mail or email this information to:

Russ Paustian
Florilli Logistics, LLC.
PO Box 186
West Liberty, IA 52776
Fax: 775-314-3351

Please provide the following:
Carrier Name
Address
City
State		Zip
Toll Free Number		Local Phone
Fax
MC#		Fed Tax ID#
Dispatch Contact Names
Email Address
After Hours Phone
Equipment Information
Number of Power Units		Number of Vans
Number of Reefers		Number of Flatbeds
Specialized Equipment
Do you carry pallets	YesNo
Primary traffic Lanes
Additional Comments
Thank you for your cooperation in providing this information so we may better serve your organization.