To apply, please take a moment to fill-out the form below. Required documents are to be supplied by you and/or downloaded using the provided links, completed, signed, and returned to us. (Please use the contact information at the bottom of this page.)

General Information * Indicates Required Fields Date* (MM/DD/YYYY) Name of Carrier* Mailing Address*

City* State/Province* Select State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AB BC MB NB NF NS ON PE PQ SK NT YT ZIP*

Telephone Numbers*  (Two contact numbers required) Area Phone No. Ext. Type Office Home Pager Cell Fax Toll-Free Office Home Pager Cell Fax Toll-Free

M.C.#* SCAC* Federal I.D.#* D.O.T. Rating* Equipment Type* E-mail Address*

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Required Documents Documents are to be supplied by you and/or downloaded using the provided links, completed, signed, and returned to us. (Please use the contact information at the bottom of this page.) Check to acknowledge: * I will supply a complete copy of my operating authority, covering both: (1) the commodities of freight, and (2) the areas in which I am authorized to operate, as per FHWA requirements. * I will supply a current, valid certificate of insurance for the insurance types listed below, with Extra Mile Transportation, LLC listed as a certificate holder (check insurance types): Cargo Insurance   Auto Liability   Workman's Compensation * I will supply my Federal I.D. or Social Security number (form W-9 preferred). * I will sign and submit one copy of the Extra Mile Motor Carrier Contract. * I will sign and submit one copy of the Extra Mile ICC License. * I will sign and submit one copy of the Extra Mile Surety Bond. * I will submit the Extra Mile Online Credit Application. * I will provide three (3) service references. Note: downloadable documents are in PDF format, and require the free Adobe Reader. PLEASE REMEMBER TO PROVIDE US WITH THREE (3) SERVICE REFERENCES PLEASE FAX REQUIRED DOCUMENTS TO (716) 276-2087 AS SOON AS POSSIBLE If we can be of any assistance, please feel free to contact us. Thank you. Extra Mile Transportation, LLC 4295 Harris Hill Road Buffalo, New York 14221   Phone:  716.276.2045 Toll Free:  800.649.4939 Fax:  716.276.2087