Carrier Remittance & Data Sheet

Note! The following information must be COMPLETED IN FULL to register your company with SPI International Transportation:
  General Company Information
Full Legal Company Name:  *
"Doing Business As" (DBA) Name:  *
Referring Party or Office:
Physical address (PO box not acceptable)
Address:  *
City:  *
Country  *
State/Province
  *
Zip/Postal Code  *
Phone  *
Toll Free  
Fax
Co. Web Site:
Identifiers
DOT Lkt#:
National Safety Code (NSC)#:
MC#:  *
Federal ID#:
Social Security # (if sole proprietor):
**If you do not have a valid MC number, please enter 'N/A'.**
  Insurance Information
Contact
Contact Name:  *
Email:
Phone:  *
Fax:
Workers Compensation
WCB Number Juristiction Location
WCB Expiry
Insurance Carrier
Cargo Insurance
Vendor
Policy #
Amount $
Broker
Insurer
Deductible
Reefer Coverage:
Delay Coverage:
Legal Liability Broad Form
Start Date
End Date
Auto Liability Insurance
Insurance Vendor
Policy #
Amount $
Broker
Insurer
Deductible
Reefer Coverage:
Delay Coverage:
Legal Liability Broad Form
Start Date
End Date
  Dispatch Contact Information
Dispatch Contact: Rates Contact:
Dispatch Phone: Rates Phone:
Dispatch Fax: Rates Fax:
Dispatch Email:
After Hours or Emergency Contact: Do you use dispatch / load management software?: Yes No
After Hours or Emergency Phone: If so, which system?
Do you have EDI capability? Yes No
  Receivables Contact Information
Receivables Contact:
Receivable Contact Email:
Receivables Phone:
Receivables Fax:
Would you be interested in SPI International Transportation contacting you about carrier finance and software rental solutions?
Show Main Information   Payment Remit Information
Important! Will you be sending your invoices to SPI International Transportation through a factoring company? Yes No
Remit to company name
(if different than above): 		 *
Remit Address:  
City:  
Country
State/Province
Zip/Postal Code  
Remit Phone
Remit Toll Free
Remit Fax
Remit Email
Contact Name
Account Number
Apply for "Quick Pay" processing of payments to my company.
  Operations Information

Click regions on the map to the right to add them to your list of preferred states/provinces.

To remove a region from your list of preferred states/provinces, select the region code in the list and click the "Remove" button.

 
Preferred States/Provinces:
  Types of Equipment
  Services
Please check if your services include:
HAZMAT
Teams
Air Ride
Expedited
Bonded Freight
Smartway Certified
Comments 
  Customs Information
US Custom Bond Number:    Canadian Custom Bond Number:   
US Custom Bond Amount ($): Canadian Custom Bond Amount ($):
Is your company registered with USA/CDN Customs and Border Protection(CBP) as a Free and Secure Trade(FAST) Registered Highway Carrier for loads coming from Canada into the USA? Yes No
FAST Card Number: How many drivers have a FAST Card:
Is your company C-TPAT certified (Customs Trade Partnership Against Terrorism)? Yes No
  • Information on applying for the C-TPAT and FAST program to go to www.cbp.gov under Quicklinks, click on C-TPAT, there is information and links for applying to both programs.
(Standard Carrier Alpha Code-issued by the NMFTA)SCAC Code:
  • To apply for a SCAC code, go to http://www.nmfta.org or call (703) 838-1831. Once the certificate of assignment is issued, it must be faxed to test
Do your drivers currently have the carrier specific PAPS (Pre-Arrival Processing System) barcodes: Yes No

You can ask any customs broker to have PAPS labels made for your company once you have a SCAC code, You can alternatively have your local printer make them, but make sure you have all the information in the proper spot, size, font, etc, or ir will not be allowed.

For a complete list of all Custom Broker Filer codes(required on PAPS barcodes) got to wwww.cbp.gov, go to Importer, then Broker Management.

Click "Next" to complete the carrier/broker agreement.
After completion of the agreement, please send the agreement and all supporting documentation to carriersetup@spitrans.com