Agent Profile

Please create your CDN Agent Profile. Please check that the information is accurate and select the "Submit Profile" button at the end of this page.
Business Information
Primary Contact Name
Company Name
Company Address
City, State, Zip
Federal ID
Duns number
Number of Employees
Number of Dispatchers
Years in Business
Owner Name

Customer References

Reference 1
Name
Phone
Since...(date)

Reference 2
Name
Phone
Since...(date)

Reference 3
Name
Phone
Since...(date)

Contact Information
phone		800 phone
fax		email
pager		emergency number
Billing Contact		phone
Accounting Mgr		phone
Dispatch Contact		phone
Sales Contact		phone

Describe your general service here:

What distance from your facility can you handle on a daily basis?
Specialty

Facility Information
Total Square Feet		Ceiling Height
Do you use Fork Lifts		yes no
Do you use Clamp Trucks?		yes no
Security		yes no
On-sight or Alarm Security?		On-sight alarmed
Insured?		yes no
Bonded?		yes no
Is facility owned or leased?		yes no
Hours of operation for deliveries
Hours of operation for receiving
Hours of operation for Customer Service
Terminal Location		Number of doors
Terminal Location		Number of doors
Terminal Location		Number of doors

Insurance and Authority
Do you have cargo insurance?	yes no
What amount of cargo insurance?
Do you have liability insurance?	yes no
What amount of liability insurance?

Interstate Authority

yes no

Intrastate Authority

yes no

Driver Information
How many company drivers?
How many owner operators?
Are your drivers bonded?	yes no
Do your drivers wear uniforms?	yes no
Are your drivers trained?	yes no
If your drivers are trained, in what and how are they trained?

How do you communicate with your drivers?	Cell Phone Pager 2-way Radio other

Specialty

Please describe what you consider to be your specialty in service or product:

General Operational Information
Do you perform home deliveries?	yes no
Do you deliver to homes and apartments?	yes no
Do you have vehicles with lift gates or ramps?	yes no
Do you make deliveries with 2 men on truck?	yes no
Do you have a cross-dock facility with truck access?	yes no
How many square feet of dock space do you have?
Appliances
Have you delivered appliances before?	yes no
Are your drivers well trained to deliver appliances?	yes no
What types of appliances?
Have you installed appliances before?	yes no
Do you remove old appliances?	yes no
Can you dispose of old appliances?	yes no
Furniture
Have you delivered furniture before?	yes no
Are your drivers well trained to deliver furniture?	yes no
What types of furniture?
Do you install or assemble furniture?	yes no
Do you remove old furniture?	yes no
Do your trucks carry blankets, straps, trailer locks, etc..?	yes no
Cabinets
Have you delivered cabinets before?	yes no
Are your drivers well trained to deliver cabinets?	yes no
What types of cabinets have you delivered?
Do you install or assemble cabinets?	yes no
Bedding
Have you delivered bedding before?	yes no
Are your drivers well trained to deliver bedding?	yes no
What types of bedding?
Do you install or assemble bedding?	yes no
Do you remove old bedding?	yes no
Millwork (bay windows, doors, etc..)
Have you delivered millwork before?	yes no
Are your drivers well trained to deliver millwork?	yes no
What types of millwork?
Electronics
Have you delivered electronics before?	yes no
Are your drivers well trained to deliver electronics?	yes no
What types of electronics?
Have you installed electronics before?	yes no
Do you remove old electronics?	yes no

Equipment Information
How many straight trucks do you have?		with Lift Gate/Ramp
How many Tractors do you have?		with Lift Gate/Ramp?
trailer/length		trailer/length
How many cars?		How many vans?
How many padded vans?		How many padded trucks?
How much warehouse space do you have?		How much refrigerator space do you have?

Computer Information
Do you have a PC?	yes no
Do you have a modem?	yes no
Modem Speed:	2400 9600 14400 28800
Modem Com Port:	com1 com2 com3 com4
Rate yourself with the PC:	excellent good fair dummy
Operating System:	DOS Win 98 Win Me Win Nt Win 2000 Win XP
Do you use the Interent?	yes no
Do you want to use the Internet?	yes no
Do you currently support EDI?	yes no
Do you use mileage software?	yes no
What brand of mileage software?
Do you use computerized billing?	yes no

Please check for accuracy and answer all of the questions.