Informational Sales Packet

Transcription

1 Informational Sales Packet

2 P.O. Box NE Hemlock Redmond, OR Hello! Enclosed please find pertinent information regarding Central Oregon Truck Company, Inc. as requested. We have also enclosed a Request for Credit Information that we ask you to complete and return via fax to (541) at your earliest convenience. Information submitted in your own format is acceptable provided it contains the same information requested on our information sheet. In that event, we require that you sign and date our form accepting our payment terms and return it with your information. If you are a freight brokerage, please include a copy of your MC license and your bond or trust documentation when you return the credit application. If you are planning on shipping into Canada we will also need to send a Supply Chain Security Questionnaire to be completed and returned. This questionnaire is available upon request and must be completed prior to Central Oregon Truck Company hauling any loads into Canada. Thank you in advance for taking the time to complete our form. Should you have any questions or if more information is required, please do not hesitate to contact Cathy Duran at ext. 3053, or Wiskie Stout at ext Thank you, Sales Department Central Oregon Truck Company, Inc. Our Mission: To be the #1 provider of flatbed transportation services in the US as measured by our safety ratings, employee satisfaction and retention, and our customers satisfaction.

3 P.O. Box NE Hemlock Redmond, OR Administration: (800) , Sales & Planning: (800) , Fax (541) Credit Application Business Legal Name: DBA NAME: Business Address: Billing Address: Telephone: Fax: Business Entity is: ( ) Sole Proprietorship ( ) Partnership ( ) Corporation Number of years in business: FEIN or SSN #: DUNS #: MC # (if you are a freight broker): (attach copy of authority) This company is a Subsidiary or Division of: If the relationship is subsidiary, please provide the FEIN # of the parent company If you are a publicly traded company, please provide the website where investor information is located A/P Contact: A/P Phone: A/P A/P Fax: Preferred delivery method of invoices: Fax US Mail Fax #/ address Delivery documents are maintained in COTC files and are available upon request Preferred method of payment: ACH* or Check *ACH is selected, banking information will be forwarded upon credit approval. Do you use a web based tendering service? Yes* No *If Yes, please attach information sheet Officer or Owner(s): Name: Title Address: Our Mission: To be the #1 provider of flatbed transportation services in the US as measured by our safety ratings, employee satisfaction and retention, and our customers satisfaction.

4 Officer or Owner(s) continued: Name: Title Address: Name: Title Address: Name: Title Address: Has the ownership or control of the business changed during the past 10 years? Yes No If yes, please explain: Have you ever filed bankruptcy: Yes No If yes, please explain: Are you doing business under any other names: Yes No If yes, please give name(s) and location(s), use additional page if necessary: Banking institution: Phone No.: Acct No.: Contact: References: Must provide four transportation trade references Company Name: Contact: Address: Phone: Acct No.: Fax: Company Name: Contact: Address: Phone: Acct No.: Fax: Company Name: Contact: Address: Phone: Acct No.: Fax: Company Name: Contact: Address: Phone: Acct No.: Fax: Page 2 of 3

5 Terms and Conditions of Account In Support of the application, Central Oregon Truck Co, Inc. (COTC) is hereby authorized to obtain credit and/or financial information from my bank, other financial institutions or commercial accounts with whom I have done business. It is understood that any such credit and/or financial information will be held in strict confidence and used only in consideration of this application. Upon approval of this application, it is agreed that all invoices will be paid in full no later than 15 days from the date of the invoice. Past due invoices are subject to 1.0% per month late fee (annual 12%) or such amount allowed by law beginning on the 16th day after the date of invoice. Should I not pay Central Oregon Truck Company, Inc. according to these terms, it is understood that credit privileges may be withdrawn. I agree to pay all attorney fees, collection fees and/or court costs incurred by COTC to collect any past due amounts hereunder, whether legal action is filed or not. Venue and jurisdiction for any dispute hereunder shall lie in Crook County, Oregon. SHIPPER: BY: PRINTED: TITLE: DATE: Page 3 of 3

6 P.O. Box NE Hemlock Redmond, OR SALES CONTACTS (800) Rick Williams, ext Chief Executive Officer Cale Pearson, ext President/National Sales Trent Sieler, ext Director of Inside Sales Ashlie Cantrell, ext Sales Specialist Heavy Haul Division Julie Souza, ext Director of Logistics Matt Ellsworth, ext Sales Specialist Mid-West/East Coast Marty Hess, ext Logistics Specialist 11 Western States Dustin Jacobson, ext Sales Specialist N. CA/N. NV/S. OR Dylan Stott, ext Sales Specialist S. CA/AZ/S. NV Mandy Franks, ext (Alabama) Logistics Specialist Mid-West/East Coast Christy Young, ext Logistics Specialist Mid-West/East Coast Griffin Webb, ext Logistics Specialist Heavy Haul/West Coast Jonathan Rosen, ext Sales Specialist - E. OR/E. WA/ID/MT/WY/ND/SD/UT/CO jrosen@cotruck.net Luke Williams, ext Director of Operations N. OR/W. WA lwilliams@cotruck.net Our Mission: To be the #1 provider of flatbed transportation services in the US as measured by our safety ratings, employee satisfaction and retention, and our customers satisfaction.

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13 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Nikki Russell United Risk Solutions, Inc. PHONE FAX PO Box 936 (A/C, No, Ext): (A/C, No): Medford, OR nikki.russell@unitedrisk.com INSURED Central Oregon Truck Company, Inc. P.O. Box 889 Redmond, OR ADDRESS: CENT01C INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : General Ins Co of America INSURER B : Great West Casualty Company INSURER C : American States Insurance INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) CLAIMS-MADE OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG POLICY PRO- JECT X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) B X ANY AUTO GWP65036F 09/01/ /01/2015 BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) NON-OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE (PER ACCIDENT) Trl Intchg UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED X RETENTION -0- WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT OP ID: CDS 11/20/2014 1,000,000 A X 24CC /01/ /01/2015 1,000,000 X 100,000 1,000,000 2,000,000 2,000,000 1,000,000 X Trl Inchg 45,000 X 1,000,000 B X CEP00144B 09/01/ /01/2015 1,000,000 B Cargo / Broad Form GWP65036F 09/01/ /01/ ,000 Limit Reefer Brkdw Incl 5,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) C: Excess General Liability - Policy # 01XS ,000,000 LIMIT CERTIFICATE HOLDER FOR INFORMATION ONLY CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

14 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB CERTIFICATE OF LIABILITY INSURANCE OCCUR OCCUR CLAIMS-MADE EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG EACH OCCURRENCE AGGREGATE DATE (MM/DD/YYYY) 3/26/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER KPD Insurance PO Box 784 Springfield OR INSURED CENT03W Central Oregon Truck Company Inc. dba Central Oregon Truck Company PO Box 889 Redmond OR COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS CONTACT NAME: PHONE (A/C, No, Ext): ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : FAX (A/C, No): INSURER(S) AFFORDING COVERAGE SAIF Corporation COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) DED RETENTION A WORKERS COMPENSATION /1/2014 4/1/2015 X WC STATU- X OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 1,000,000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 NAIC # DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All Operations CERTIFICATE HOLDER CANCELLATION Sample Certificate.... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

15 PRODUCER CONTACT NAME: PHONE (A/C, No, Ext): ADDRESS: INSURER A : INSURED INSURER B : Central Oregon Truck Company Inc dba INSURER C : Central Oregon Truck Co INSURER D : 394 NE Hemlock Avenue INSURER E : Redmond, OR INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 5/14/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). USI Midwest 234 Spring Lake Drive Itasca, IL Client#: DASEKINC Mary Macnak FAX (A/C, No): mary.macnak@usi.biz INSURER(S) AFFORDING COVERAGE NAIC # National Fire & Marine Insuranc A X UMBRELLA LIAB X OCCUR 42RLO /01/ /01/2015 EACH OCCURRENCE 8,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE 8,000,000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR INSR WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) CLAIMS-MADE OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) HIRED AUTOS AUTOS NON-OWNED PROPERTY DAMAGE (Per accident) DED RETENTION WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER **SPECIMEN** CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1 of 1 #S /M ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MEMAA