24 Hour Breakdown Assistance
For Trucks and Trailers
1-888-635-0005
Breakdowns Happen
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Service Providers

BECOME A TRUCKERS ASSIST QUALIFIED SERVICE PROVIDER

1

Step One. Fill out the simple form below.

2

Step Two. Get qualified by one of our service reps.

3

Step Three. Start getting your business noticed!

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Please complete the registration form and a staff member from our Vendor Management Team will contact you within one business day to obtain any additional information required to complete the registration.

Service Provider Registration

Company

Address

Main Contact

Services Provided

Qualification Criteria

Pricing/Rates Information

Mechanical Repairs
Time Hours Labor
($/hr)		 Mileage
$/mile (If Any)		 Service Call (If Any)
Business Hours
After Hours

Additional Comments
Towing & Recovery
Time Hours Labor
($/hr)		 Hookup Fee
($)		 Mileage
($/mile)
Business Hours Tractor Only
After Hours Tractor Only
Business Hours Trailer
After Hours Trailer
Track & Trailer Towed In Tandem

Additional Comments
Tires
Time Hours Labor
(Hourly/Flat Fee)		 Mount/Dmt ($) Disposal ($) Mileage
$/mile (If Any)		 Service Call (If Any)
Business Hours
After Hours

Additional Comments

I hereby confirm that the above information, supplied by myself, is correct in every respect. Furthermore, I have read and fully understand and agree with your terms and conditions provided.