Affiliate – Cooper Global Chauffeured Transportation

Affiliate Agreement

Company Name(Required)

DBA Name

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Toll Free Phone Number

Main Phone Number

Company Website

Reservation Email

Emergency Phone

Is your company outside the US?

Yes

Tax ID#

CC/DOT Permits #

Please upload a Copy of COI

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Max. file size: 256 MB.

Please upload a copy of your W9

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Max. file size: 256 MB.

Please upload your General company information & survey

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Max. file size: 256 MB.

Name

This field is for validation purposes and should be left unchanged.