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Credit Application

Please fill out the form below.

Thanks for Filling out the Prime Trailer Leasing Credit Application. Please follow the Instructions and We will get back to you as quickly as possible.

INSTRUCTIONS:

Online Submission: Please fill out the form below Entirely and click send.

Print and Fax Submission: Fill out this PDF form, print it out and send it over to us for review. the PDF is found at the bottom of the page.

Prime Trailer Leasing Fax Number: 303-467-9601

INSURANCE REQUIREMENTS

A Certificate of Insurance is Required in Order to Rent a Trailer. Please read below for all the information we need from you so we can match you with the right trailer.

Over the Road and Cartage Trailer Rentals

Prime Trailer Leasing Requires Companies to have a COI that has us as the following:

Loss Payee
Additional Insured

Applicable deductibles must be listed

Auto Liability Coverage with Prime Trailer Leasing named as Additional Insured. Covered needs to be primary with a cancellation notice of 30 days preferred. A minimum limit of $1,000,000 is required; lower limits (to $750,000 minimum) will be evaluated on an individual basis.

STORAGE TRAILERS
Liability coverage in the form of Auto or General Liability is required. Prime Trailer Leasing must be named as Additional Insured. Covereage needs to be primary with a cancellation notice of 30 days preferred. A minimum limit of $1,000,000 is required; lower limits will be evaluated on an individual basis.

Storage trailers picked up or returned by the customer must have Auto Liability.

Physical Damage coverage with us named as Loss Payee. Coverage may be in the form of Inland Marine, Contractors Equipment or other coverage that provides comprehensive coverage for the equipment rented. Applicable deductibles must be listed.

Company Name that Appears as Certificate Holder Should Read:

Prime Trailer Leasing
10400 E 102nd Ave
Henderson, CO 80640

All Fields Are Required and Must Be Filled In Completely

If You Do Not Know an Answer, You Can Fill in NA or Similar. We Appreciate You Filling The Application Out Completely and Look Forward to Serving Your Trailer Needs.

Contact Us

Full Name of Primary Contact:

Primary Account Phone #:

Primary Account Email:

Company Name:

Billing Address:

City/State/Zip:

Telephone #:

Fax #:

Federal Tax ID # (NOT SSN):

Year Business Established:

Trade References

Company Name:

Address:

City/State/Zip:

Contact Name:

Telephone #:

Fax #:

Length of Relationship:

High Credit Amount in $:

Current Balance $:

Terms/Net Payment:

Additional Comments:

Trade References #2

Company Name:

Address:

City/State/Zip:

Contact Name:

Telephone #:

Fax #:

Length of Relationship:

High Credit Amount in $:

Current Balance $:

Terms/Net Payment:

Additional Comments:

Trade References #3

Company Name:

Address:

City/State/Zip:

Contact Name:

Telephone #:

Fax #:

Length of Relationship:

High Credit Amount in $:

Current Balance $:

Terms/Net Payment:

Additional Comments:

Bank Reference

Bank Name:

Contact Name:

Address:

Telephone #:

Fax #:

Account Number:

Average Monthly Balance $:

Date Account Opened:

Additional Bank Reference

Bank Name:

Contact:

Address:

Telephone #:

Fax #:

Account Number:

Average Monthly Balance $:

Date Account Opened:

I Give Prime Trailer Leasing Authorization to Conduct a Bank Reference Credit History on this Company (Sign Name):

Signed:

Fleet Statistics

Number of Trucks Owned:

Number of Trucks Leased/Rented:

Number of Trucks for Owner/Operators:

Average Age of Trucks:

Number of Trailers Owned:

Number of Trailers Leased/Rented:

Number of Trailers for Owner/Operators:

Average Age of Trailers:

Current Aggregate Monthly Loan/Lease Payments:

Current Aggregrate Monthy Operating Lease Payments:

Total Monthly Payments:

Insurance Information

Insurance Company Name:

Agent:

Agent #:

Do You Have a Self-Insurance Program?:

Additional Information

Accounts Payable Contact:

Accounts Payable Contact #:

Accounts Payable Contact Email:

Would You Like To Receive Emails on Promotional Offers on Trailer Rentals?

Would You Like To Receive Emails on Current News Regarding Prime Trailer Leasing?

How Did You Hear About Us?:

Signature

My Signature Below Gives Authorization to PRIME TRAILER LEASING To Do a Trade Reference Credit Check and Bank Reference Credit History On This Company

Signature (Full Name):

Date:

Thank You For Filling Out Prime Trailer Leasing's Credit Application - If You Have Any Questions, Please Contact Us and We Will Be Glad to Assist You!

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Credit Application

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