New Account Application

Step 1 - Company Information

Legal Business Name *

DBA (If Different)

Billing Street Address *

City *

State *

Postal / ZIP Code *

Business Phone *

Business Email *

Business Type *

Federal Tax ID / EIN *

Primary Type of Work *

Step 2 - Company Contacts

Primary Company Contact (Full Name) *

Primary Company Contact (Phone Number) *

Primary Company Contact (Email) *

Accounts Payable / Billing Contact (Full Name) *

The person who handles invoices

Accounts Payable / Billing Contact (Phone Number) *

Accounts Payable / Billing Contact (Email) *

Step 3 - Account Setup & Terms

Requested Terms *

Estimated Rental Volume (How Many Trailers / Month) *

Step 4 - Insurance

Insurance Agent / Broker (Full Name) *

Insurance Agent / Broker (Phone Number) *

Insurance Agent / Broker (Email) *

Current Policy Number

If Known - Otherwise will provide COI prior to first rental

Certificate of Insurance (COI) - File Upload

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Step 5 - Acknowledgement & Signature

Applicant Signature *

Clear

Applicant Full Name *

Applicant Job Title *

Today's Date *

I certify that the information provided is accurate. I understand this application establishes an account with Freez Bros Rentals LLC and does not itself constitute a rental agreement — each individual rental remains subject to Freez Bros Rentals LLC's Rental Agreement Terms & Conditions, executed at time of checkout.

Freez Bros Rentals