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Step 1 - Company Information
Note: All required fields are marked with a *

Company Name
* Legal Name:
DBA:
Please enter the password you would like to use for your account. This is the password you will use to log in to GTLI.net.
* Password:
* Verify Password:
The IRS requires we obtain a physical address. PO boxes are not physical addresses!
Physical Address
* Address:
Address 2:
* City/State/Zip: ,
 
Mailing Address (if different from physical address)
Address 1:
Address 2:
City/State/Zip: ,
 
Remit To Address (if different from mailing address)
Name:
Address1:
Address2:
City/State/Zip: ,
 
Phone/Fax Numbers
* Phone Number: ( )- - Alternate Number: ( )- -
Toll-Free Number: ( )- - 24hr Number: ( )- -
Cell Number: ( )- - Fax Number: ( )- -
Management Contacts
Title * Name * E-mail Address
* Owner/CEO:
Operating Manager:
Sales Manager:
Step 2 - Operating Information
Operating Authority
* USDOT#: * Federal ID#
or SSN:		 -
- -
* Carrier MC#: Broker MC#
FF#: MX# (Mexico):
Intrastate # / State: /
* Select the types of authority that you have (check all that apply):
Insurance Information (please enter full names)
* Insurance Company:
* Agent's Name:
Agent's Phone Number ( )- -
Liability Company: Expires: / /
Cargo Company: Expires: / /
Worker's Comp Company: Expires: / /
Exclusions:
Operations
* Select the types of carrier operation (check all that apply):
Number of teams:
* Number of power units (trucks) we run:
Satellite tracking for trucks:


Commodities that you WILL NOT haul:
If you have additional terminals, where are they located?:

Step 3 - Equipment

Please enter the quantity of each type of equipment and check all features that apply.

Type Length Quantity 102" Air Ride Vents Heater
Van 48'
50'
53'
57'
Curtain Van 48'
50'
53'
Reefer 48'
50'
53'
 
Type Length Quantity 102" Air Ride Tarps Straps
Flatbed 48'
50'
53'
Step Deck 48'
50'
53'
Drop Deck 48'
50'
53'
Specialized Equipment:

Step 4 - Preferred Lanes

Please check all states and provinces you need freight in and out of.

Dedicated or preferred lanes:
* Origin City/State: /
* Destination City/State: /
* Frequency (per week):
* Equipment:
Rate:
 

Interested in loads FROM the following US States:
Alabama Illinois Montana Rhode Island
Alaska Indiana Nebraska South Carolina
Arizona Iowa Nevada South Dakota
Arkansas Kansas New Hampshire Tennessee
California Kentucky New Jersey Texas
Colorado Louisiana New Mexico Utah
Connecticut Maine New York Vermont
Delaware Maryland North Carolina Virginia
District of Columbia Massachusetts North Dakota Washington
Florida Michigan Ohio West Virginia
Georgia Minnesota Oklahoma Wisconsin
Hawaii Mississippi Oregon Wyoming
Idaho Missouri Pennsylvania
Interested in loads TO the following US States:
Alabama Illinois Montana Rhode Island
Alaska Indiana Nebraska South Carolina
Arizona Iowa Nevada South Dakota
Arkansas Kansas New Hampshire Tennessee
California Kentucky New Jersey Texas
Colorado Louisiana New Mexico Utah
Connecticut Maine New York Vermont
Delaware Maryland North Carolina Virginia
District of Columbia Massachusetts North Dakota Washington
Florida Michigan Ohio West Virginia
Georgia Minnesota Oklahoma Wisconsin
Hawaii Mississippi Oregon Wyoming
Idaho Missouri Pennsylvania
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