Carrier Application

APPLICATION FOR SERVICE

Company Information Form

Are you a Freight/Property Broker? (brokers arrange for the truck transportation of cargo belonging to others, for compensation, utilizing for hire carriers to provide the actual truck transportation.) YesNo
Are you a Common/Contract (Independent) Carrier? (provide for-hire truck transportation directly to the shipper (i.e. directly to us, no broker involved), you own and operate your own fleet.
NOTE:you must notify us immediately if your status changes from Common/Contract carrier to that of a Freight Broker.

Contact Information:

Office Contact:

Insurance Contact:

Dispatch Contact:

Company is able to haul for which of the following plants:

Please list any other information that may help with contacting your company. Also, specify if your company has different billing entities.

Price Quote Information Form(Applications without rates will not be accepted)

Foley Products Company – Local Haul Rates

Miles Fuel Price
$2.01 to $2.50 $2.51 to $3.00 $3.01 to $3.50 $3.51 to $4.00 $4.01 to $4.51
0-25
26-50
51-75
76-100

* Please complete the “Rate Chart”above with your flat rate for each column up to 100 miles. For 101 miles or greater please provide your rate per mile below:

Foley Products Facilities–Point to State Rates:

ORIGIN AL FL GA LA MS NC SC TN
Newnan, GA/Winder, GA
Clanton, AL/Athens, AL
Prentiss, MS

Fuel surcharge –Rates should bebased upon a $3.00/gallon price of fuel according to the Lower Atlantic average. Rates will adjust $.02/mile for every $.05/gallon change, either positively or negatively,in the price of diesel fuel.

EXTRA CHARGES