U-Quote Freight.com

*Please be sure to fill out entire the entire form.

Company Name: _________________________________________________________________
Date: ____________ Phone: ________________ Fax: __________________
Type of Business: __________________________________________________
Amount of Credit Requested: ________________________________________
Contact Person: ___________________________________________________

Address: __________________________________________________

__________________________________________________

City: ____________________ State: _______ Zip: _____________

Year Established: _________ Years at present Address: __________ D&B: __________

Business Structure (Circle One):
Corporation Partnership Sole Proprietorship LLC

*If Corporation: State of Incorporation: ________ State Corp. #: _________ Fed. ID #: _________

Owners / Partners / Corporate Officers:

Name: Title Address, City, State, Zip Phone

_________________ ___________ _______________________ __________________

Banking References Address, City, State, Zip Phone

_________________ _____________________________________ __________________

Account #: _________________________ Contact Person: _________________________

Trade References

Firm Name Address, City, State, Zip Phone

__________________ _____________________________________ _________________

I/We do hereby acknowledge the following terms and conditions of Freight Management and Allocation Company (FMAC). There must be notice to FMAC of ownership changes to our company by certified mail. All freight bills shall be paid within "net 15" terms. In the event that terms are not met, any freight discount is subject to revocation, at FMAC's discretion. I/We hereby authorize FMAC to contact the above credit/trade references. If our company defaults on payment of outstanding invoices, we agree to pay reasonable attorney and collection expenses, in connection therewith. I/We also agree to resolve any and all disputes, mediation and or arbitration not withstanding, pursuant to California State law. I/We expressly agree and consent to the exclusive, jurisdiction of the Courts of the State of California, in the Los Angeles County, Van Nuys Judicial District. FMAC is both a freight broker and freight forwarder under the Federal Highway Administration. As such, the following term is dependent upon the method by which FMAC renders service, on each order. I/We agree that, where FMAC acts as a freight broker, no remittance shall be delayed or withheld because of unsettled claims or other items which shall be the sole responsibility of the carrier, not the broker, FMAC. Where FMAC acts as a freight forwarder, there is a distinction between payment of freight charges and liability for damage or loss of freight, and we expressly agree that no remittance shall be delayed or withheld because of unsettled claims or other items which shall be primarily the responsibility of the actual carrier. Delivery dates and service standards are estimates only, no delivery guarantees, as to specific dates and times, are made. By My/Our signature below I/We hereby acknowledge these distinctions, and agree to make payment for freight charges within the above terms.

Authorized Company Representative:

_______________________________ Date:______________

Signature (Required)

Please Print Name and Title:

_________________________ ________________________
Name Title

U-Quote Freight.com
(is a service offered by)
Freight Management and Allocation Company
21133 Victory Blvd., Suite. 221, Canoga Park, CA 91303
Phone: (888) or (800)303-1245 Fax: (888)303-1243
E-mail: uquote@fmac.com