FusionNetwork Registration

Thank you for your interest in joining Logico's FusionNetwork.

Please complete the form below. The status bar will keep you advised of your overall progress. Once you have completed a section, click the [NEXT] button to proceed forward. You can always return to a previous section using the [PREVIOUS] button at the bottom of any page.

Before beginning the registration process, please make sure that you have the following documents ready to upload:
- Insurance Certificates - General, Auto & Cargo Liability (Listing Grupo Logico, LLC as a certificate holder)
- Operating Authorities (48 States, Intra-States, Canadian, Freight Forwarder, Broker)
- Completed W-9 Form (Click here to download)
- Logico Carrier Contract (Click here to download)
- Minority Certificate
Insurance Certificates*
Accepted file types: pdf, jpg, gif, Max. file size: 8 MB.
Operating Authorities
Accepted file types: pdf, jpg, gif, Max. file size: 8 MB.
Completed W-9 Form
Accepted file types: pdf, jpg, gif, Max. file size: 8 MB.
Logico Carrier Contract*
Accepted file types: pdf, jpg, gif, Max. file size: 8 MB.
Minority Certificate
Accepted file types: pdf, jpg, gif, Max. file size: 8 MB.
* Indicates required fields.

Accepted file types: .pdf, .jpg, .gif

Company Information
Please provide the following information about your company.
Company Name:*
US DOT:
Authority (MC/FF):
Federal Tax ID:
SCAC:
C-TPAT Certification:
Safety Rating:
Minority Certified?
MWBE Type:
MWBE Expiration:
MM slash DD slash YYYY
HazMat Certified?
EDI Capable?
* Indicates required fields.
Address
Please provide the physical address where your company is located and the remit-to address (If different).
Physical Address:*
Company Name Address City State / Province Postal Code Country
Mailing/Remit Address:
(Payment Remit to Address / Factoring Company Address)

Same as Physical Address

Company Name Address City State / Province Postal Code Country
* Indicates required fields.

Contact Information
Please provide a complete list of contacts. Please include after-hours contacts. (Click the plus (+) symbol to add additional contacts.)
Operations
Full Name Title Office Ext Fax Mobile Email

Up to 5 contacts.
Accounting
Full Name Title Office Ext Fax Mobile Email

Up to 5 contacts.
Sales
Full Name Title Office Ext Fax Mobile Email

Up to 5 contacts.
Notifications Emails*
Please indicate the email address or group where Logico should send the following notifications.
Load Tenders Freight Bids
EDI Capable?*
Logico's EDI specifications are available to download from our website.

Company Information

Full Name	Title	Office	Ext	Fax	Mobile	Email

Full Name	Title	Office	Ext	Fax	Mobile	Email

Full Name	Title	Office	Ext	Fax	Mobile	Email