LET URTRUCKBROKER BE YOUR BROKER OF CHOICE!

Size: px
Start display at page:

Download "LET URTRUCKBROKER BE YOUR BROKER OF CHOICE!"

Transcription

1 45 Dyke Thomas, Texarkana, TX fax cell What we offer Carriers and Owner Operators 1. Cost Plus Fuel Card 2. Checks mailed in 21 days We use SevenOaks Capital Associates LLC 3. 3 day quick pay 4. Permit service 5. Load planning (pre-plan return load finding service) 6. Truck and Fleet Management 7. Government Freight 8. Trip Planning 9. EFS Fleet services 10. Insurance discounts (group rates) 11. Submit paperwork via Fax, , or Smart Phone 12. Direct Deposit or EFS express code % Fuel Advance once pickup is confirmed 14. Free secure address 15. Free Website and hosting. 16. Sams club membership for drivers that haul 2 or more loads per year. LET URTRUCKBROKER BE YOUR BROKER OF CHOICE!

2 URTRUCKBROKER CARRIER BROKER ID ID AGENT: URTRUCKBROKER CORP Carrier: To: Fax: Subject: Transportation Contract From: CONTRACT DEPT. - CONTRACT INSTRUCTIONS: Complete this contract and return before hauling for UrTruckBroker. Use Black blue or black Blue ink only if and filling out or by sign hand, ALL Initial pages. each section of agreement and Sign Page must be signed by an Officer of the company and survey must be completed and returned. The You ACH will receive form is confirmation mandatory, if once you factor your payment fill it out with options their have ACH been information, set up. no load dispatched until complete. Fax all pages back to us at or to accounts@urtruckbroker.com Include: Copy of Authority W-9 Copy of insurance Insurance listing UrTruckBroker Corp as certificate as certificate holder holder, Request for insurance verification form must be (we filled must out have completely. proof that you have no exclusions in your cargo policy for Tire, Copper, or Electronics.) UrTruckBroker Corp 45 Dyke Thomas Texarkana, Tx Fill out Carrier Profile. No Any changes to you the contract make to terms your contract are permitted will delay without processing. permission UrTruckBroker will execute your signed contract and fax or mail our signature copy back to you. URTRUCKBROKER CORP US DOT ICC MC Representative Initial: Carrier Agreement

3 BROKER AGREEMENT FOR MOTOR CARRIER CONTRACT SERVICES THIS AGREEMENT (hereinafter referred to as "the Contract") is made and entered into on this day of 20 in Texarkana, Texas, by and between the following named parties (hereinafter referred to as "the Parties"): UrTruckBroker Corp, a business with its principal place of business at 45 Dyke Thomas, Texarkana, TX 75501, for itself and on behalf of its affiliated companies and divisions which are also parties to this Contract, collectively hereinafter referred to as "UrTruckBroker Corp Corp"and, with its principal place of business at, Herein after referred to as "Carrier". US DOT ICC MC EIN WITNESSETH WHEREAS, Carrier performs motor carrier transportation services in one or more of the following forms: as a motor contract carrier duly registered with the Federal Motor Carrier Safety Administration ("FMCSA") in Docket No. MCas a motor carrier that solely transports cargo that is exempt from regulation by the FMCSA ; or U.S. DOT# as a motor carrier performing drayage services for inter-modal shipments in good standing with the Inter-modal Association of North America (IANA) and the Uniform Inter-modal interchange Agreement (UIIA); or as a motor carrier transporting cargo in Intrastate, Interstate, Inter Provincial/Territorial or Mexico-U. S. Intra-Provincial/Territorial movements; and WHEREAS, UrTruckBroker Corp arranges transportation of property by motor carriers for its customers and is duly registered as a Property UrTruckBroker Corp with the FMCSA in Docket No. MC as may be amended from time to time and also facilitates the same to the extent that Carrier performs services pursuant to this Contract within, or to or from Mexico; and WHEREAS, UrTruckBroker Corp desires to use the services of Carrier to transport property for or on behalf of its customers and Carrier desires to provide transportation services to UrTruckBroker Corp's Customers; and NOW, THEREFORE, in consideration of the foregoing premises and the mutual promises contained herein, Carrier and UrTruckBroker Corp agree as follows: _ Initial CONTRACT TERMS AND TERMINATION This Contract shall be effective as of the date written above and shall continue for a period of one year. This Contract shall thereafter continue in effect from year to year on the same terms and conditions, unless terminated by either party. Either Party shall have the right to terminate this contract upon thirty (30) days' prior written notice to the other party. US DOT ICC MC Rep Initials: 1

4 SHIPMENTS TO BE TENDERED BY URTRUCKBROKER CORP UrTruckBroker Corp hereby agrees to tender shipments to Carrier as its needs require for transportation in Interstate, Intrastate, Inter-Provincial/Territorial, Intra-provincial/ Territorial or foreign commerce, and Carrier hereby agrees to transport such shipments in accordance with the terms and conditions stated in this Contract. INDIVIDUAL SHIPMENT COMPENSATION AND TERMS Compensation shall be paid to Carrier solely and exclusively by UrTruckBroker Corp, and not by UrTruckBroker Corp's customers, on all shipments tendered to Carrier under this Contract. Carrier shall be compensated by UrTruckBroker Corp based on the following: Carrier and UrTruckBroker Corp may orally agree upon the rate or compensation to be paid to Carrier for, and the terms and conditions applicable to, any shipment tendered by UrTruckBroker Corp under this Contract. UrTruckBroker Corp shall subsequently confirm the oral agreement by issuing a confirmation to Carrier in written or electronic format ("the Confirmation") that sets forth the rates, terms, and conditions agreed upon. Unless Carrier objects to the contents of the Confirmation within twenty-four (24) hours of receipt, Carrier shall be deemed to have assented to the Confirmation, which shall be binding. Each Confirmation shall be incorporated into and considered to be a part of this Contract, and the Parties agree to retain all such confirmations for at least three (3) years subsequent to the expiration of this Contract, or longer to the extent required by law. Unless the rate for any shipment is agreed to by Carrier and stated on the Confirmation, the rates and charges for the shipment shall be computed at $.80 per load mile. B. Carrier and UrTruckBroker Corp may agree in a separate agreement, such as UrTruckBroker Corp's "Quick Pay Discount Agreement" set forth in Appendix A, etc. ("Discount Agreement"), to apply a discount to the rates and charges set forth in this Contract and all applicable Confirmations, which separate agreement shall be incorporated into and considered to be a part of this Contract. If the Parties agree to the Discount Agreement, the discounted amount shall be the compensation owed to Carrier for shipments covered by the Discount Agreement without additional notation on any Confirmation issued by UrTruckBroker Corp. c. Carrier agrees that any tariffs, circulars, pricing authorities, and/or similar documents that it publishes shall not apply to the transportation services provided by Carrier under this Contract, unless any such tariff, circular, pricing authority or similar document is expressly incorporated into this Contract or into a Confirmation. US DOT ICC MC Rep Initials: 2

5 PAYMENT OF RATES AND CHARGES Within twenty (25) days after UrTruckBroker Corp's receipt of Carrier's delivery receipt (or as otherwise provided by a Discount Agreement), UrTruckBroker Corp shall pay Carrier the rates and charges applicable to the shipment. In exchange for UrTruckBroker Corp's guarantee of prompt payment, and other good and valuable consideration, Carrier (i) appoints and designates UrTruckBroker Corp as its agent for the purpose of billing and collection of freight charges and, notwithstanding subsection(7)(1) of the Mercantile Law Amendment Act of Ontario or any other similar legislation, Carrier waives any and all rights to claim, demand, or pursue payment from any person other than UrTruckBroker Corp for any shipment tendered pursuant to this Contract; (ii) agrees not to contact UrTruckBroker Corp's customers, consignors, consignees or any party other than UrTruckBroker Corp concerning payment for transportation services; and, (iii) agrees to indemnify, defend, and hold UrTruckBroker Corp, its customers, consignors, and consignees harmless from any claim or demand made by any subcontractor of carrier or other party for payment for transportation services related to a shipment tendered under this Contract. In its sole discretion, UrTruckBroker Corp may withhold compensation owed to Carrier to satisfy claims or shortages arising out of this or other Contracts with Carrier, or to satisfy advances made to, or on behalf of, Carrier, or to satisfy any debt owed by Carrier to UrTruckBroker Corp or any of its subsidiary or related companies, including EFS- Check Systems, Inc. UrTruckBroker Corp's right to withhold compensation shall arise only if the underlying claim or debt has not been acknowledged in writing by Carrier within thirty (30) days of presentation by UrTruckBroker Corp, or the claim or debt has neither been paid nor denied for a valid reason within ninety (90) days of presentation. UrTruckBroker Corp's withholding of compensation shall not allow or permit Carrier to seek payment from UrTruckBroker Corp's customers, consignors, consignees, or any other third party, and Carrier agrees that it shall not, under any circumstances, claim, demand, or pursue payment from UrTruckBroker Corp's Customers', consignors, consignees, or other parties for transportation services provided hereunder. Any claim for overpayment or underpayment for transportation services provided pursuant to this Contract shall be presented by the party asserting the claim to the other party within sixty (60) days of discovery of the claim, but in no event will any such claim(s) be asserted more than one hundred eighty (180) days after the delivery of the shipment or shipments giving rise to any such claim. Claims shall be supported by appropriate documentation showing the amount of the overcharge or the undercharge, as the case may be. The parties shall pay, deny, or make a firm compromise offer within forty-five (45) days of receiving a claim. Any civil action to recover overcharges or undercharges shall be instituted within eighteen (18) months of the date of delivery of the shipments comprising the overcharge or undercharge claim. US DOT ICC MC Rep Initials: 3

6 Carrier will pay all licenses, fees, taxes, fuel tax payments, road tax, equipment use fees or taxes, equipment license fees, driver's license fees, tolls and any other fees and fines that may be assessed on its equipment or its operations. CARRIER'S OPERATING AUTHORITY AND SAFETY RATING Carrier represents and warrants that all transportation performed under this Contract shall be contract carriage. To the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, it shall procure and maintain any and all operating authorities or permits required to be held by Carrier under any applicable Federal, Provincial or Territorial laws and shall adhere to the Canadian National Safety Code. Without cost to UrTruckBroker Corp, Carrier shall provide and ensure complete all preventive maintenance and ongoing maintenance including, but not limited to, periodic safety inspections, annual safety inspections and emissions testing pursuant to the standards set out in any and all of the applicable motor vehicle statutes and regulations of the applicable jurisdiction(s) of operation. Carrier warrants that it shall notify UrTruckBroker Corp in the event of any suspension, cancellation, termination, or withdrawal of its operating authorities, in which event UrTruckBroker Corp shall have the right to terminate this Contract immediately upon written notice to Carrier. Carrier further represents and warrants that it shall at all times maintain a U.S. DOT safety rating that is "satisfactory", (subject to UrTruckBroker Corp's policies as amended from time to time), or "unrated"; and if to the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, comparably, Carrier shall maintain a Canadian "carrier safety rating" that is "satisfactory", or "un-audited" in accordance with the Ontario Ministry of Transportation standards pursuant to the Highway Traffic Act and Regulations and/or any other Provincial or Territorial equivalent, which has jurisdiction over the Carriers operations. Carrier warrants that it will promptly notify UrTruckBroker Corp if Carrier is assessed an "conditional" or "unsatisfactory" safety rating, or if any equipment is known to be or reported as defective or which is not in compliance with the applicable Federal, State, Provincial or Territorial statute or regulation pertaining to vehicle or highway safety and UrTruckBroker Corp will suspend all service with Carrier and until such time that the Carriers rating is upgraded to "Satisfactory". To the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, Carrier warrants that it holds a valid registration with the Commercial Vehicle Operator's Registration (CVOR) System for transporting goods through Canada. Carrier shall notify UrTruckBroker Corp immediately of any conviction or sanction against its CVOR rating. To the extent that Carrier performs services pursuant to this Contract within, or to o r from Canada, Carrier holds a valid license or certificate to operate an Extra- Provincial truck undertaking, and to engage in the Intra-Provincial truck Transportation of goods or valid overweight permits pursuant to any applicable laws if necessary or as US DOT ICC MC Rep Initials: 4

7 issued under the Motor Vehicle Transport Act, 1987 or any Highway Traffic Act or equivalent as applicable to the jurisdiction of the trip/route. To the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, Carrier is authorized to transact bonded highway carrier operations in Canada, and warrants that it holds the applicable bonded highway carrier code as issued by the Canada Border Services Agency ("CBSA"). To the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, Carrier has signed Partners in Protection memorandum of understanding with the CBSA and has been certified and/or validated by the United States Bureau of Customs and Border Protection ("CBP") as a participant in the Customs-Trade Partnership Against Terrorism. To the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, Carrier warrant that it is an approved carrier under the CBSA's Customs Self-Assessment program, and is a registered participant in the Free and Secure Trade ("FAST") program and that it holds a Standard Alpha Code number as issued by the National Motor Freight Association ("NMFTA"). DRIVERS AND EQUIPMENT Carrier shall ensure that its drivers are properly trained and licensed, and are competent and capable of safely handling and transporting UrTruckBroker Corp's shipments. Carrier agrees that drivers will be dispatched in accordance with the maximum available hours of service as provided in rules promulgated by the FMCSA while in the United States or as provided by any Canadian authority whose jurisdiction is within Carriers route/trip. Carrier shall provide and maintain all equipment required for the services requested by UrTruckBroker Corp and shall only use and provide equipment that is clean, in good operating condition and repair, in compliance with any and all Federal and/or State, Provincial/Territorial, Municipal statutes and regulations, and is suitable and properly configured to safely load, transport, and unload the shipments tendered by UrTruckBroker Corp. Carrier shall ensure that all equipment and all loads are in compliance with the environmental standards of any and all jurisdictions on its route and must act in accordance with these environmental standards. Any deviation from prescribed environmental standards is contrary to UrTruckBroker Corp's policy and the Carrier shall be solely and independently responsible for any consequence flowing from said deviation. All equipment provided for the transportation of food or food grade products will comply with the requirements of The Sanitary Food Transportation Act, or, to the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, the Food and Drug Acts and any/all other applicable statutes and regulations, including, but not limited to the Ontario Food Safety and Quality Act, 2001, or any other jurisdiction's US DOT ICC MC Rep Initials: 5

8 equivalent, and that none of the equipment so provided has been or will be used for the transportation of any waste of any kind, garbage, hazardous materials or any other commodity that might adulterate or contaminate food, food products or cosmetics. Drop Trailer/Interchange. In the event that Carrier participates in a drop trailer arrangement for the benefit of any of UrTruckBroker Corp's customers or vendors, Carrier agrees that it shall address all damage or liability issues directly with the responsible customer or vendor. Carrier agrees that UrTruckBroker Corp shall only be responsible for the direct acts of its employees, and not for the actions of customers, lumpers, draymen, other carriers, or any other third party. If Carrier agrees to interchange equipment to another carrier or to use equipment owned by a third party, Carrier, will address any interchange agreement directly with that motor carrier or equipment owner. Equipment Use/Commingling. Carrier agrees not to commingle or consolidate any freight tendered by UrTruckBroker Corp with the freight of any of Carrier's other customers. With regard to the individual tenders accepted by Carrier from UrTruckBroker Corp, Carrier's equipment shall be dedicated exclusively to the use of UrTruckBroker Corp's tendered loads in accordance with each Confirmation. Exception can be granted with prior consent and in the case of a particular shipment being an LTL shipment. Carrier's violation of this exclusive use requirement shall result in, as a liquidated damage and not as a penalty; Carrier's forfeiting its right to be paid for the transportation services as contemplated by the Confirmation. UrTruckBroker Corp shall also have the right to terminate this Contract immediately upon written notice to Carrier. CELL PHONES AND LOAD TRACKING Carrier agrees that they will discourage the use of hand held cellular devices while the vehicle is in operation. Carrier further agrees that texting while driving is forbidden while transporting any freight for UrTruckBroker Corp. UrTruckBroker Corp utilizes a load tracking app for the protection of everyone involved in a shipment. It allows the Shipper, Broker and Carrier to identify the location of the load at their convenience. This is a mandatory app install for all drivers. Any Driver refusing to install the app will not be given the load. The Carriers rate tender and confirmation will be withdrawn or not issued and no compensation for deadhead or other services will be given. This app cannot be disabled or turned off while the carrier is in possession of a UrTruckBroker Corp load. The app will automatically disable itself within 24 hours of delivery or can be disabled by driver after UrTruckBroker Corp has received the empty call from the driver and a copy of the signed Bill of Lading. In the event the driver disables the app while under dispatch with a UrTruckBroker Corp load, the carrier will be assessed a penalty of $ per day for the entire dispatch with no credit given for connected days. It is the responsibility of the driver to keep his phone charged and turned on at all times while assigned a UrTruckBroker Corp load. US DOT ICC MC Rep Initials: 6

9 PERFORMANCE AND DELIVERY TIME Carrier shall transport shipments to their specified destination without delay caused by anything in Carrier's control and with reasonable dispatch, unless a specified delivery date and/or time is communicated to it prior to the pick-up of any individual shipment, in which case delivery shall be performed in accordance with the communicated schedule. COMPLIANCE WITH LAWS Carrier agrees that all transportation services will be performed in full compliance with Federal, State, Provincial, Territorial, Municipal, local, and, to the extent applicable, international laws or regulations governing its operations (including but not limited to the statutes and regulations of any Provincial or Territorial Highway Traffic Act or equivalent, the Transportation of Dangerous Goods Act and regulations and the regulations of the Federal Department of Homeland Security ("DHS"), the Transportation Security Agency ("TSA"), as well as any legislation and related programs designed to protect transportation activities from terrorist attacks, such as the Customs - Trade Partnerships Against Terrorism and the Free and Secure Trade initiative. Carrier agrees to indemnify UrTruckBroker Corp for any fines, costs, claims, liability or expenses that it may occur and that arise out of violations of any applicable laws and regulations during Carrier's performance under this Contract. SHIPMENT INSTRUCTIONS At the time each shipment is received by Carrier from UrTruckBroker Corp's customer, Carrier will request and obtain instructions concerning all handling, securing and freight protection requirements, including specifications noted on the bill of lading, on shipment instructions, or as otherwise may be provided. Carrier is responsible for insuring that all freight is properly blocked and braced for transportation pursuant to any applicable Canadian National Safety Standards, or other applicable standards, unless tendered to Carrier in a pre-loaded, sealed trailer, in which case Carrier shall note the seal numbers on the bill of lading or receipt. The goods being shipped shall be considered to be in apparent good order and condition, unless otherwise indicated by Carrier or receiver on the bill of lading. URTRUCKBROKER CORP'S COMPENSATION Carrier shall not claim or demand, in whole or in part, UrTruckBroker Corp's commissions earned by UrTruckBroker Corp on shipments tendered under this Contract, pursuant to 49 CFR US DOT ICC MC Rep Initials: 7

10 INDEPENDENT CONTRACTOR Carrier is an independent contractor and shall exercise exclusive control, supervision, and direction over the manner in which transportation services are provided; the persons engaged in providing transportation services; and, the equipment selected and used to provide transportation services. Carrier shall have full responsibility for the payment of local, state, and federal payroll taxes, workers compensation and other social security and related payment requirements with respect to all persons engaged in the performance of transportation services. This Contract does not create, nor shall it be deemed to create a partnership, joint venture, or agency relationship between UrTruckBroker Corp and Carrier. CARRIER'S CARGO LIABILITY AND CLAIMS Carrier shall have the sole and exclusive care, custody and control of the shipments tendered by UrTruckBroker Corp from the time Carrier picks up a shipment until delivery to the consignee. Carrier shall be liable UrTruckBroker Corp for actual loss and damage to shipments, and for delayed deliveries, arising from Carrier's performance of or failure to perform the services required by this Contract; provided, however, that Carrier shall not be liable for loss, damage, or delay to shipments caused solely by an act of God, public enemy, acts of war, insurrection, riot, inherent vice of the Shipment, or the negligence of UrTruckBroker Corp or its customer, in which case Carrier has the burden of proving applicability of the exception. Any seals applied to trailer are not to be broken or removed prior to delivery at destination without prior written consent from UrTruckBroker Corp. Carrier shall be liable for the full, actual value of the shipments tendered by UrTruckBroker Corp to Carrier. No released value rates, or other limitation of cargo liability, shall be valid or enforceable against UrTruckBroker Corp or its customers unless expressly agreed to by UrTruckBroker Corp in a signed writing separate from any bill of lading or other delivery receipt issued by Carrier. UrTruckBroker Corp may file a claim for loss or damage to shipments delivered or not delivered. Within ninety (90) days of receiving a claim from UrTruckBroker Corp for loss, damage, or delay, Carrier shall pay or deny the claim (in which case the reasons for denial shall be fully explained), or make a firm compromise offer. In the event branded or labeled goods are damaged, UrTruckBroker Corp's customer may determine, in its sole discretion, whether the goods may be salvaged, and if salvageable, the value of such salvage. Any salvage receipts shall be deducted from the amount of UrTruckBroker Corp's claim against Carrier. If UrTruckBroker Corp's customer permits its goods to be salvaged and Carrier pays the full, actual value of the damaged goods US DOT ICC MC Rep Initials: 8

11 Carrier may retain custody of the goods after removing all identifying marks and labels. To the extent that any of the terms of this contract are inconsistent with the Highway Traffic Act, R.S.O. 1990, c. H.8, as amended, and the Regulations thereto or similar provincial or territorial legislation having jurisdiction, and/or the provisions of any bill of lading, the terms of this Contract shall prevail. INSURANCE Unless greater insurance limits are required on a schedule to this Contract or by law, Carrier agrees to procure and maintain at its own expense the following insurance in at least the following amounts during the term of this Contract: Cargo Insurance: $100,000 per shipment or, to the extent that Carrier performs services pursuant to this Contract within, or to or from Canada, an amount sufficient to cover the loss or damage to the cargo carried, but in no instance less than $100,000 per shipment; Cargo Insurance shall not have any exclusions for Copper, Tires or Electronics Automobile Liability Insurance: $1,0000,000 USD per occurrence; Worker's compensation: as required by law; Any additional BMC 32 and MCS 90 Endorsements or requirements where required by law or regulation; (Note: possessing a General Liability insurance policy and insurance limits in excess of the minimums outlined above will result in greater freight opportunities for Carrier). Carrier shall furnish written evidence of its insurance coverage to UrTruckBroker Corp upon request and shall advise UrTruckBroker Corp of any change in its insurance coverage thirty (30) days prior to the effective date of such change. Carrier further agrees to procure and maintain any and all insurance required by federal, state, Provincial, Territorial, Municipal, local, or to the extent applicable, international laws. Carrier shall cause the required insurance to be procured naming UrTruckBroker Corp as "additional insured" on any Public Liability, General Liability and/or Automobile liability policies, and as "loss payee" on the Cargo policy. Upon request of UrTruckBroker Corp, Carrier shall furnish to UrTruckBroker Corp written certificates obtained from each insurance carrier showing that the required insurance has been procured. Carrier's liability for cargo loss or damage described in Section 12 above and its indemnification described in Section 14 below will not be reduced or limited by the actual insurance policy limits that Carrier chooses to purchase. US DOT ICC MC Rep Initials: 9

12 URTRUCKBROKER CORP CARRIER'S INDEMNIFICATION Carrier shall indemnify, defend, and hold UrTruckBroker Corp, its customers, consignors, and consignees, and their respective parent, subsidiaries, affiliates, employees, officers, directors and agents harmless from and against any and all losses, harm, injuries, damages, claims, costs, expenses, and liabilities (including reasonable legal fees) arising from, or in connection with services provided by Carrier, its employees, agents, and contractors, unless resulting directly from the negligence or willful act or omission of UrTruckBroker Corp or its customers and their consignors or consignees and their respective parent, subsidiaries, affiliates, employees, officers, directors and agents. BILLS OF LADING AND DELIVERY RECEIPTS Carrier will issue and sign a standard, uniform straight bill of lading or other receipt ("Receipt") acceptable to UrTruckBroker Corp and UrTruckBroker Corp's customers upon acceptance of a shipment for transportation. If Carrier permits the shipper to prepare the bill of lading, Carrier warrants that it shall ensure that the bill of lading properly names Carrier as the "carrier" on the load prior to signing it, and shall strike through and correct any erroneous designation of any other person as "carrier" (including UrTruckBroker Corp) on the bill of lading. Any terms and conditions written or printed on the Receipt shall have no effect against UrTruckBroker Corp, unless specifically agreed to by UrTruckBroker Corp in this Contract or in a separate signed writing apart from the Receipt. The Receipt issued or executed by Carrier shall be prima-facie evidence of receipt of the shipment in good order and condition by Carrier unless otherwise noted on the face of said document. Carrier shall submit an original copy of the Receipt to UrTruckBroker Corp evidencing delivery of the shipment unless otherwise instructed by UrTruckBroker Corp, in which case Carrier shall retain custody of the Receipt and provide it to UrTruckBroker Corp upon request. If Carrier fails to maintain and provide the Receipt, Carrier assumes all risk of loss resulting from the failure to prove good delivery. PAPERWORK SUBMISSION FOR PAYMENT TO CARRIER Carrier shall within 24 hours of delivery submit to UrTruckBroker Corp proof of delivery in form of signed BOL (bill of lading) and/or Delivery receipt. Further the Carrier shall submit to UrTruckBroker an invoice for the carriers services within 48 hours of delivery. The proof of delivery documents and invoice are to be submitted by fax or ONLY to accounts@urtruckbroker.com or fax Any billing paperwork submitted via Fedex, UPS, US Mail or other parcel delivery service can expect up to 60 delay in processing without penalty to UrTruckBroker Corp. The only exception to these terms is in a case where the shipper is requiring original US DOT ICC MC Rep Initials: 10

13 documents for payment and will be clearly noted on the carriers rate confirmation sheet. FACTORING Carrier shall provide UrTruckBroker Corp written notice of any assignment, factoring, or other transfer of its right to receive payments arising under this Contract thirty (30) days prior to such assignment, factoring, or other transfer taking legal effect. Such written notice shall include the name and address of assignee/transferee, date, date assignment is to begin, and terms of the assignment, and shall be considered delivered upon receipt of such written notice by UrTruckBroker Corp. Carrier shall be allowed to have only one assignment, factoring or transfer legally effective at any one point in time, and no multiple assignments, factoring or transfers by the Carrier shall be permitted. Carrier shall indemnify UrTruckBroker Corp against and hold UrTruckBroker Corp harmless from any and all lawsuits, claims, actions, damages (including reasonable attorneys fees, obligations, liabilities and liens) arising or imposed in connection with the assignment or transfer of any account or right arising thereunder where the Carrier has not complied with the notification assignment requirements of this section. Carrier also releases and waives any right, claim or action against UrTruckBroker Corp for amounts due and owing under this Contract where Carrier has not complied with the notice requirements of this section. SUBCONTRACTORS Carrier specifically agrees that it shall be the party solely responsible for operating the equipment necessary to transport commodities under this Contract and that it shall not, in any manner, sub- contract, UrTruckBroker Corp or tender to any third party for transportation any freight tendered to Carrier pursuant to this Contract. In the event that Carrier shall employ any subcontractor or other person for the performance of all or any portion of the services required hereunder to be performed by Carrier, Carrier shall be and remain liable to UrTruckBroker Corp under the terms of this Contract including, without limitation, liability for loss, damage or delay of any shipments, whether such loss, damage or delay occurred while such shipment was in the possession of Carrier or such subcontractor or other person. Carrier shall be solely and exclusively responsible to pay any charges of any subcontractor or other person and agrees to indemnify and defend UrTruckBroker Corp and its customers from and against any claims made by any such subcontractor or other person in connection with its provision of services required to be performed by Carrier hereunder. Notwithstanding the terms of this provision, if Carrier violates this Contract UrTruckBroker Corp any freight tendered to Carrier pursuant to this Contract, UrTruckBroker Corp may, in its sole discretion, do one or more of the following: terminate this Contract and UrTruckBroker Corp's relationship with Carrier; and/or require the Carrier to immediately provide security (cash, bond or letter of credit) in a minimum amount of $50,000, or such greater amount required by UrTruckBroker Corp, US DOT ICC MC Rep Initials: 11

14 URTRUCKBROKER CORP to secure Carrier's liability to carriers it engages. Carrier further acknowledges and agrees that UrTruckBroker Corp may, in its sole discretion, withhold payment to Carrier and make payment directly to carriers it engages. COMMUNICATIONS AND CONFIDENTIALITY Carrier and UrTruckBroker Corp shall endeavor to communicate by the most effective and efficient means to exchange information, including instructions, rates, equipment, shipment location, and other information helpful or necessary to achieve the intentions of the Parties herein. Such communications and information transmission presently includes telephone, telecopier, software, , internet, electronic data interchange, satellite, and information received from third parties (including affiliates of UrTruckBroker Corp, outside billing companies and freight payment entities), but this is not intended to be limiting the manner of future communications as they develop. All information furnished by one Party to the other in the course of performing work or rendering services under this Contract shall be deemed to be the confidential and proprietary information of the disclosing Party and/or its customers. The Party receiving information agrees not to disclose any such information unless required to do so by order of court or other legally constituted tribunal, nor to use such information other than in performance of work and/or services under this Contract. Carrier agrees not to use UrTruckBroker Corp customers' names for promotional or other purposes without prior written consent. ASSIGNMENT Neither party shall assign this Contract or any rights hereunder without the prior written consent of the other party, except that UrTruckBroker Corp may assign this Contract to any of its parent, subsidiary or related companies, or to any surviving company in a merger or acquisition. Any assignment made pursuant to this paragraph shall be binding upon all assigns, heirs, and successors of the assigning party. NOTICES Except for regular business communications which may be transmitted through procedures established by agreement or acquiescence, all notices made hereunder shall be provided in writing and delivered by telecopier, certified mail, or overnight courier. Notices transmitted by telecopier shall be deemed received as of the date and time of confirmation printed by sender's machine. Notices transmitted by certified mail or overnight courier shall be deemed received as of the date and time signed for by recipient. Notices shall be addressed to the respective parties as set forth above. US DOT ICC MC Rep Initials: 12

15 URTRUCKBROKER CORP FORCE MAJEURE Neither UrTruckBroker Corp nor Carrier shall be liable for any delay in the performance of their respective obligations under this Contract resulting from any force majeure, including, but not limited to, acts of God, acts of government or other civil or military authorities, acts of terror, war or riots. Whenever possible, in the event of a force majeure, the affected party shall promptly notify the other party in writing, stating the reasons for the inability to comply with the provisions of this Contract, and the expected duration of the force majeure. NO LIEN Carrier shall have no lien, and hereby expressly waives its right to any lien on any cargo, freight, or property of UrTruckBroker Corp or any of its customers, consignors or consignees. ENTIRE AGREEMENT This Contract constitutes the entire agreement and understanding between the parties and supersedes any and all prior agreements and understanding, either oral or written. EXECUTION This Contract may be executed in one or more counterparts and each such counterpart shall, for all purposes, be deemed to be an original, but all such counterparts shall together constitute but one and the same instrument. FEES In the event either party incurs attorney/lawyers fees, costs, or expenses in enforcing any of the provisions of this Contract, or in exercising any right or remedy arising out of any breach of this Contract by the other party, the prevailing party shall be entitled to receive attorney/lawyers fees, costs and expenses from the other party. CHOICE OF LAW The Parties agree that this Contract shall be governed by, construed and enforced in accordance with the laws of the State of Texas, or, to the extent that Carrier performs services pursuant to this Contract within. The parties further agree that all disputes arising under this Contract may be submitted to the jurisdiction of the State or Federal Courts within the State or District of Texas. The parties hereto have specifically requested that this agreement be drawn up in the English language only. US DOT ICC MC Rep Initials: 13

16 MODIFICATIONS TO CONTRACT With the exception of additional operational requirement and/or shipping instructions set forth in the Confirmation and/or associated written instruction issued by UrTruckBroker Corp, no modification of this Contract and waiver of any of its terms shall be valid or binding unless made in a writing duly executed by the authorized representatives of both parties. SEVERABILITY If any provision of this Contract held to be invalid under the laws of the Federal government, any State, Province, Territory, Municipality or any other jurisdiction having authority, such provision will be deemed to have no effect but all other provisions of this Contract shall remain in full force and effect. WAIVER The Parties have entered into this Contract pursuant to 49 U.S.C (b) for the purpose of providing and receiving transportation services under the rates and conditions set forth in this contract. The Parties expressly waive any and all rights and remedies permitted to be waived under the Interstate Commerce Commission Termination Act, to the extent that such rights and remedies are inconsistent with any of the provisions of this Contract. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed as of the date and year first written above. "The undersigned hereby represents and warrants that they are duly authorized to execute this instrument on behalf of: Carrier By: signature Name: printed name Title: Date_ (If signing as a member of an LLC or Corporation you must include a copy of your Formation Certificate.) UrTruckBroker Corp By: signature Name: printed name Title: Date US DOT ICC MC Rep Initials: 14

17 CARRIER ID AGENT: Please select one payment option and one payment method: Payment Options (select one option) 1 Standard Pay Carriers You will receive payment within twenty one (30) 21days after UrTruckBroker has received all completed and legible paperwork of the load. 1 Quick Pay Carriers Your payment will be released within 72 hours (not including Saturday, Sunday, or certain National Holidays) less a discount of 4.0% of the gross freight bill amount and UrTruckBroker has received all completed and legible paperwork of the load. *You must fill out and sign the Appendix A Quick Pay Discount Agreement. 1 Factoring Fax a letter of assignment that is signed and dated. We **you do not will issue be on paper a paper checks, check you are until require we have to fill your out the payment ACH form options for yourself entered or into your our factoring system. You company. will receive The a only confirmation other method fax of or payment that is via your Bank payment Wire and setup there has is a $25.00 been completed.** fee if you accep this method. In rare cases you can receive an EFS express code. Payment Methods (select one option) 1 EFS- Account you can have your payments directly deposited into your EFS Account. *Enter your EFS Account # here: Wire fee may apply ACH 1 EFT(Electronic Funds Transfer) you can have your payments directly deposited into your checking or savings account. *You must fill out the EFT Funds Transfer Authorization Form. *You must also include a copy of a voided check. ComChek 1 EFS-Check Express Code you will receive a express code for an EFS-Check for your payment. You are required to call into our office ( ) to receive your Express Codes. Fees apply 1 Paper Check you will receive a paper check via U.S. Postal mail. URTRUCKBROKER CORP US DOT ICC MC Representative Initial: Carrier Agreement

18 URTRUCKBROKER CARRIER ID (Only fill out this form if you ve selected Quick Pay as your payment option) You must also complete the quick pay portion on the ACH form (accept or deny QUICK PAY DISCOUNT AGREEMENT APPENDIX A By executing this Appendix A, Carrier is requesting that UrTruckBroker make early payment of freight charges in exchange for a discount of the agreed rates provided for in Article 3 of the Agreement for Motor Contract Carrier Services. Upon final completion of the load, and after providing the necessary documents to confirm completion of Carrier s responsibilities without loss or damage, UrTruckBroker agrees to pay to Carrier the amount of the freight bill as confirmed by UrTruckBroker, less a discount of 4 % of the gross freight bill amount. Upon receiving the necessary documents (and after allowing for a reasonable processing time), UrTruckBroker will make payment within 72 hours,(excluding Saturdays, Sundays, and Holidays) in a manner designated by Carrier, which may consist of (a) depositing the amount via electronic funds transfer ( EFT ) into Carrier s bank account, or (b) depositing the funds into Carrier s EFS Account, or (c) issuing a EFS-Check Authorization number to Carrier for the same, or (d) delivery of check, or (e) any other method that may be agreed between UrTruckBroker and Carrier. Carrier shall provide UrTruckBroker with written payment instructions (on a form provided by UrTruckBroker), and agrees to hold UrTruckBroker harmless from any claims or damages that may arise from payment by UrTruckBroker according to Carrier s instructions. Carrier understands and agrees that it may take up to 10 business days from the execution of this Quick Pay Discount Agreement to begin processing of the Quick Pay Payment Program. Carrier DBA Name By: (sign by an officer of the company) TITLE: (Owner/Officer of the company) By: (Print name of officer of the company) DATE: URTRUCKBROKER CORP US DOT ICC MC Representative Initial: Carrier Agreement

19 SevenOaks Capital Associates, LLC Carrier Payment Policy Please be advised that SevenOaks Capital Associates has entered into a factoring relationship with UrTruckBroker Corp.. SevenOaks payment policy is to pay U.S. based carriers days via ACH** after receipt of acceptable invoice and original bill of lading. SevenOaks Capital Associates does offer a Quick Pay option in which payment will be made via ACH to the carrier within business hours after acceptable documentation is received. In return for Quick Pay SevenOaks Capital will deduct a 4% discount from the carriers invoice. Please indicate below if you would like to participate in our Quick Pay program. Only companies that are directly paid are eligible for Quick Pay. If you factor your receivables, you will not be eligible for quick pay with SevenOaks. **Non-U.S. Based Carriers must be paid by check and sent via Fed Ex. Please complete this form and fax to or accounts@urtruckbroker.com terri@sevenoakscaptial.com. Please attach a voided check to process via ach, or complete the authorization and banking information below to ach all future payments COMPANY NAME: SIGNATURE: PRINT NAME: TITLE: ACCOUNT TITLE: ACCT #: BANK ROUTING#: BANK NAME: Quick Pay Authorization Only complete if you are electing to have quick pay-if you decline complete the lower portion By signing this agreement, is acknowledging that their receivables are not paid to a third party, and is requesting to enroll in SevenOaks quick pay program. The signature below authorizes SevenOaks to deduct 3% from the carrier s invoices. Signature-Authorized Agent of Carrier Date Printed Name/Company If you are declining Quick Pay Complete the lower portion Quick Pay Decline Signature-Authorized Agent of Carrier Printed Name/Company Date Factoring Party for Carrier

20 Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: Individual/sole proprietor or C Corporation S Corporation Partnership Trust/estate single-member LLC Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) 5 Address (number, street, and apt. or suite no.) 6 City, state, and ZIP code 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) Requester s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number or Employer identification number Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: Form 1099-INT (interest earned or paid) Form 1099-DIV (dividends, including those from stocks or mutual funds) Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) Form 1099-K (merchant card and third party network transactions) Date Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) Form 1099-C (canceled debt) Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No X Form W-9 (Rev )

SEQUOIA TRANSPORTATION SERVICES, INC.

SEQUOIA TRANSPORTATION SERVICES, INC. SEQUOIA TRANSPORTATION SERVICES, INC. AGREEMENT FOR MOTOR CONTRACT CARRIER SERVICES THIS AGREEMENT is entered into this day of, 20, by and between SEQUOIA TRANSPORTATION SERVICES, INC., a California Corporation,

More information

60 Doughboy Road, Gillett, AR 72055 Phone: 870 946 8880 Fax: 866 530 2702

60 Doughboy Road, Gillett, AR 72055 Phone: 870 946 8880 Fax: 866 530 2702 60 Doughboy Road, Gillett, AR 72055 Phone: 870 946 8880 Fax: 866 530 2702 Carrier Information Sheet Please use your company s legal name AND DBA name if one exists. Carrier Name: DBA Name: Mailing Address:

More information

$ Quick Pay: Guaranteed payment 20 days following the receipt of the POD and associated paperwork. There is a 2% discount taken for this service.

$ Quick Pay: Guaranteed payment 20 days following the receipt of the POD and associated paperwork. There is a 2% discount taken for this service. Dear Potential Carrier Partner, Thank you for your interest in becoming a carrier and partner with Grimes Supply Chain Services, INC (GSCS). We offer excellent opportunities to be a part of our team and

More information

TRANSPORT WORLDWIDE, LLC

TRANSPORT WORLDWIDE, LLC The following information is needed in order for us to set your company up as an approved carrier for TRANSPORT WORLDWIDE, LLC. Please return to: TRANSPORT WORLDWIDE, LLC 307 Oates Road Suite H Mooresville,

More information

MASTER TRANSPORTATION CONTRACT

MASTER TRANSPORTATION CONTRACT MASTER TRANSPORTATION CONTRACT This Master Transportation Contract (hereinafter Agreement ), effective as of, (Effective Date) is made by and between Dutch Maid Logistics, Inc. (hereinafter referred to

More information

NEW JERSEY PROVIDER AGREEMENT

NEW JERSEY PROVIDER AGREEMENT NEW JERSEY PROVIDER AGREEMENT Provider ID: Effective Date: This Agreement is made by and between Xerox State & Local Solutions, Inc. a New York Corporation, (hereinafter XEROX ) and, a corporation, individual(s),

More information

How To Write A Property Broker Contract Carrier Agreement

How To Write A Property Broker Contract Carrier Agreement Thank you for your interest in SIGNATURE LOGISTICS, INC. In order to set up your company in our carrier system the following information is needed. Signed Contract Carrier Agreement (return both pages)

More information

ATTENTION CARRIER! PLEASE FAX THIS COMPLETED FORM ALONG WITH THE FOLLOWING DOCUMENTS TO 315-622-5281

ATTENTION CARRIER! PLEASE FAX THIS COMPLETED FORM ALONG WITH THE FOLLOWING DOCUMENTS TO 315-622-5281 ATTENTION CARRIER! Carrier Name: PLEASE FAX THIS COMPLETED FORM ALONG WITH THE FOLLOWING DOCUMENTS TO 315-622-5281 Signed Breakaway Transport Broker/Carrier Agreement Workman s Compensation letter Copy

More information

BROKER CARRIER AGREEMENT. THIS AGREEMENT is made and entered into on, 200, by and between REED FREIGHT SERVICES, INC. ( BROKER ) and ("CARRIER").

BROKER CARRIER AGREEMENT. THIS AGREEMENT is made and entered into on, 200, by and between REED FREIGHT SERVICES, INC. ( BROKER ) and (CARRIER). BROKER CARRIER AGREEMENT THIS AGREEMENT is made and entered into on, 200, by and between REED FREIGHT SERVICES, INC. ( BROKER ) and ("CARRIER"). I. Recitals A. BROKER is a licensed transportation broker

More information

Please fax the following required paperwork to (501) 955-4998

Please fax the following required paperwork to (501) 955-4998 Dear Carrier, Thank you for your interest in becoming a carrier for Maverick Logistics, LLC. We offer excellent opportunities through competitive rates, prompt settlements, and an experienced staff. To

More information

BROKER AND CARRIER AGREEMENT

BROKER AND CARRIER AGREEMENT P.O. Box 889 394 NE Hemlock Redmond, OR 97756 BROKER AND CARRIER AGREEMENT All loads tendered by Central Oregon Truck Company ("Broker") and accepted for transportation by third party carriers ("Carrier")

More information

BROKER/SHIPPER AGREEMENT

BROKER/SHIPPER AGREEMENT BROKER/SHIPPER AGREEMENT THIS BROKERAGE AGREEMENT ( Agreement ) is made and entered on, 20, by and between ( SHIPPER ) and Transportation Solutions Group, LLC DBA Redwood Multimodal ( BROKER ) (collectively,

More information

BROKER/CO-BROKER INTERMODAL TRANSPORTATION AGREEMENT

BROKER/CO-BROKER INTERMODAL TRANSPORTATION AGREEMENT BROKER/CO-BROKER INTERMODAL TRANSPORTATION AGREEMENT THIS BROKER/CO-BROKER INTERMODAL TRANSPORTATION AGREEMENT ( Agreement ) is made and intended to be effective this day of, 20 by and between, having

More information

P.O. Box 78189, Nashville, TN 37207- (615) 271-2450 Toll Free 1-800-776-4004

P.O. Box 78189, Nashville, TN 37207- (615) 271-2450 Toll Free 1-800-776-4004 Allow us to earn your respect P.O. Box 78189, Nashville, TN 37207- (615) 271-2450 Toll Free 1-800-776-4004 ATT: PHONE#: FAX#: In order to establish your company as an approved broker - carrier for Tennessee

More information

CARRIER FILE CHECK OFF LIST

CARRIER FILE CHECK OFF LIST Mail Invoices with originals to: 12 7 th Ave SE, Suite 1, Watertown, SD 57201 Office: 605-540-4046 Cell: 605-881-4143 Fax: 605-939-7110 MC# 667252 TIN: 26-4091214 sokotalogistics@live.com AGENTS: LA Cook

More information

B R O K E R A G E P A C K E T

B R O K E R A G E P A C K E T 2330 Enterprise Park Drive, Suite 106 Indianapolis, Indiana 46218 Phone: 317-472-6411 Fax: 317-308-6425 Email: Day Dispatch: Fast@FastBrokerageInc.com Night Dispatch: AfterHours@FastBrokerageInc.com MC

More information

New Carrier Setup Information we need from you to set you up as a new carrier:

New Carrier Setup Information we need from you to set you up as a new carrier: 1762 Ridgewood Cir. Lawrenceburg, IN. 47025 Phone: 812-637-3251 Fax: 302-450-4181 New Carrier Setup Information we need from you to set you up as a new carrier: 1. Signed Carrier-Broker Agreement 2. Copy

More information

Financial Forms for U.S. Based Institutions

Financial Forms for U.S. Based Institutions ALEXION INVESTIGATOR-SPONSORED RESEARCH PROGRAM FINANCIAL FORMS FOR U.S. BASED INSTITUTIONS 1 Financial Forms for U.S. Based Institutions Your institution must submit completed financial forms in order

More information

ALL AMERICAN TRUCKING CO. LLC Carrier Sign on Checklist

ALL AMERICAN TRUCKING CO. LLC Carrier Sign on Checklist ALL AMERICAN TRUCKING CO. LLC Carrier Sign on Checklist Carrier Name: Signed Transportation Agreement between ALL AMERICAN TRUCKING CO. LLC and Carrier Copy of Carrier s PUCO Operating Authority Signed

More information

I. Completely fill out each page of our Motor Carrier Agreement, sign, and fax back. Please be sure to initial Page 2.

I. Completely fill out each page of our Motor Carrier Agreement, sign, and fax back. Please be sure to initial Page 2. Motor Carrier Packet Cover Sheet This Document is Updated: 10/1/12 Supersedes Document Dated: 6/27/12 Thank you very much for your interest in working with us. Our mission is to be much more than a broker

More information

CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions

CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions Introduction Cummings Property Management Inc. is the company that manages the administrative and financial operations of the community

More information

TRANSPORTATION AGREEMENT

TRANSPORTATION AGREEMENT TRANSPORTATION AGREEMENT THIS AGREEMENT ( Agreement ) is dated as of, 200 between including its subsidiaries (collectively, Shipper ), and Dick Harris and Son Trucking Co., Inc. (Carrier). Carrier agrees

More information

Application for Customer Status

Application for Customer Status Application for Customer Status TERMS AND CONDITIONS OF SALES: The terms and condition of sales by Perfect 10 (hereafter referred to as Perfect 10 ) to the below named Customer (hereafter referred to as

More information

Carrier Packet Requirements

Carrier Packet Requirements Carrier Packet Requirements National Transportation Services, LLC looks forward to working with you. Enclosed you will find our carrier requirements, items 1to 9 below reflect the documentation you are

More information

NOTE: We must have available in our office the following information on all carriers prior to loading

NOTE: We must have available in our office the following information on all carriers prior to loading 687 CENTER AVE P.O. BOX 758 PAYETTE, IDAHO 83661 CARRIER INFORMATION TELEPHONE 208 642 2594 800 325 4107 FAX 208 642 2057 NOTE: We must have available in our office the following information on all carriers

More information

REQUIRED FORMS FOR. In order to get set up as an approved carrier for STAT please complete and return the following documents to us. Thank you.

REQUIRED FORMS FOR. In order to get set up as an approved carrier for STAT please complete and return the following documents to us. Thank you. REQUIRED FORMS FOR CARRIER AUTHORIZATION In order to get set up as an approved carrier for STAT please complete and return the following documents to us. Thank you. 1. The STAT Dispatching & Logistics,

More information

5Star Life Insurance Company Agent & Agency Contracting Packet

5Star Life Insurance Company Agent & Agency Contracting Packet 5Star Life Insurance Company Agent & Agency Contracting Packet (Includes) Agent & Agency Data Sheet Anti-Money Laundering Training Certification Ethical Selling Guide/Guide for Doing Business with 5Star

More information

BROKER/SHIPPER TRANSPORTATION AGREEMENT

BROKER/SHIPPER TRANSPORTATION AGREEMENT BROKER/SHIPPER TRANSPORTATION AGREEMENT THIS AGREEMENT, Agreement, made and intended to be effective this (the) day of, 20 by and between having offices at ( BROKER ) and having offices at ( SHIPPER ),

More information

Terms and Conditions

Terms and Conditions Terms and Conditions Sims Global Solutions, LLC, (hereinafter referred to as Company ) is a multi- mode freight broker whether it be truckload, LTL, hotshot, intermodal rail, ocean or domestic air. Our

More information

How To Pay Shipping Invoices On A Factoring Basis

How To Pay Shipping Invoices On A Factoring Basis NEWCOMB TRANSPORTATION AND LOGISTICS SHIPPER TERMS & CONDITIONS 1. APPLICABILITY These Terms & Conditions and agreed upon pricing documents apply to all broker services (the Services ) provided by Youbulk,

More information

To qualify as a carrier provider please complete and email return this information form to us via email with a follow up call to our office.

To qualify as a carrier provider please complete and email return this information form to us via email with a follow up call to our office. To: New Carrier: Shipper s West Logistics is an extension of our exclusive partnership with Navajo Express. We work together to find the solution a customer may need for any particular project. To qualify

More information

INDEPENDENT CONTRACTOR AGREEMENT Contractor Subcontractor

INDEPENDENT CONTRACTOR AGREEMENT Contractor Subcontractor INDEPENDENT CONTRACTOR AGREEMENT Contractor Subcontractor This Independent Contractor Agreement (hereafter Agreement ) is hereby entered i n t o b y a n d b e t w e e n d/b/a (hereafter Contractor ) and

More information

Follow us on twitter @PacExLogistics for News and Industry Updates!

Follow us on twitter @PacExLogistics for News and Industry Updates! MC Number: 648132 DOT number: 1920166 Federal Tax ID#: 32-0254568 SCAC code: FMSCA Bond: (Form-85/$25,000 Trust Fund) Banking PACW Policy#648132 Pacific Financial Association Inc. 12707 High Bluff #200

More information

If you have any questions, please call 1-877-LOGISTX (564-4789).

If you have any questions, please call 1-877-LOGISTX (564-4789). Paramount Transportation Logistics Services, L.L.C. (PTLS) welcomes your interest in becoming an approved carrier for us. We are confident that you will find PTLS an easy company to do business with. The

More information

TX LOGISTICS SERVICES

TX LOGISTICS SERVICES TX LOGISTICS SERVICES CARRIER CONTRACT This Agreement effective as of the date signed by the last of the two parties (the Effective Date ) is made by and between TX Logistics Services, an operating division

More information

CHECKLIST. SIS Insurance Services 3250 Grey Hawk Ct. Carlsbad, CA 92010

CHECKLIST. SIS Insurance Services 3250 Grey Hawk Ct. Carlsbad, CA 92010 Dear Producer: SafeBuilt Insurance Services, Inc. (SIS), DBA: Structural Insurance Services (SIS) looks forward to doing business with your agency and beginning a good working relationship. CHECKLIST Legible

More information

WHOLESALE BROKER REGISTRATION PROCESS A.

WHOLESALE BROKER REGISTRATION PROCESS A. WHOLESALE BROKER REGISTRATION PROCESS A. Overview: Thank you for considering becoming a registered broker with Cherrywood Commercial Lending, LLC ("CCL"). Our registration process is outlined below. Please

More information

CARRIER/BROKER AGREEMENT

CARRIER/BROKER AGREEMENT CARRIER/BROKER AGREEMENT THIS AGREEMENT is made and entered into on, 20, by and between Lakota Logistics, LLC ("BROKER") a Michigan limited liability company whose address is 1000 County Road KE, Marquette,

More information

Action Freight Service, Inc. Expedited LTL Service Conditions Table of Contents Application of Service Conditions

Action Freight Service, Inc. Expedited LTL Service Conditions Table of Contents Application of Service Conditions Action Freight Service, Inc. Expedited LTL Service Conditions 20160302 Service Conditions.doc. Copyright 2008-2010. All rights reserved. Property of Action Freight Service, Inc. Table of Contents Application

More information

Billing and Company Information

Billing and Company Information Billing and Company Information Warren Logistics, Inc. PO Box 30 Blanchard, ID 83804 Phone (888) 253-0430 Fax (208) 962-6741 quote@warrenlogistics.com www.warrenlogistics.com S Corporation, Idaho State

More information

RETURN ALL CARRIER SET UP PAPERWORK TO FAX: (281) 810-9160

RETURN ALL CARRIER SET UP PAPERWORK TO FAX: (281) 810-9160 MOTOR CARRIER PROFILE GUFFEY & SON LOGISTICS LLC Dear Carrier Partner To be certain we have an accurate profile of your organization and full knowledge of your transportation services and needs, complete

More information

234 Fiddler Branch Road Lexington, SC 29072 803-359-9969 Fax 803-359-9487

234 Fiddler Branch Road Lexington, SC 29072 803-359-9969 Fax 803-359-9487 Dear Carrier: Thank you for your interest in doing business with Rocky Wells. You can return your Carrier Profile Packet via email to our company representative assisting you. We look forward to working

More information

WASTE SERVICES & DISPOSAL AGREEMENT. By: By: Name: Name: Title: Title:

WASTE SERVICES & DISPOSAL AGREEMENT. By: By: Name: Name: Title: Title: WASTE SERVICES & DISPOSAL AGREEMENT COMPANY: CUSTOMER: By: By: Name: Name: Date Date Title: Title: Effective Date of Agreement: Initial Term: Contract No. This Waste & Disposal Services Agreement, consisting

More information

Subcontractor Insurance & Licensing Requirements Please provide the items below

Subcontractor Insurance & Licensing Requirements Please provide the items below Subcontractor Insurance & Licensing Requirements Please provide the items below Commercial General Liability Limits of Insurance $2 Million dollars General Aggregate (Per Project) $2 Million dollars Product/Completed

More information

MASTER TRANSPORTATION AGREEMENT

MASTER TRANSPORTATION AGREEMENT MASTER TRANSPORTATION AGREEMENT This Master Transportation Agreement ( Agreement ) effective as of, 2009 is entered into and made by and between Camryn Logistics, LLC, whose address is 19785 West 12 Miles

More information

576 Valley Rd, #234 Wayne, NJ 07470 Tel: (973) 333-4922 Fax: (973) 595-7720. Attention: Date:

576 Valley Rd, #234 Wayne, NJ 07470 Tel: (973) 333-4922 Fax: (973) 595-7720. Attention: Date: Attention: 576 Valley Rd, #234 Tel: (973) 333-4922 Fax: (973) 595-7720 From: Date: Cheryl Biron I would like to take this time to thank you for your interest in becoming a qualified carrier for One Horn

More information

Loaded Up Logistics Terms and Conditions

Loaded Up Logistics Terms and Conditions Loaded Up Logistics Terms and Conditions Loaded Up Logistics (hereinafter referred to as "Company") is a Freight Logistics Company operating as a Freight Broker and is licensed by the Department of Transportation

More information

BROKER - CARRIER AGREEMENT

BROKER - CARRIER AGREEMENT BROKER - CARRIER AGREEMENT This Agreement is entered into this day of, 20, by and between ("BROKER"), a Registered Property Broker, Lic. No. MC-, and, a Registered Motor Carrier, Permit/Certificate No.

More information

Recitals. NOW, THEREFORE, the parties hereto agree as follows: Agreement

Recitals. NOW, THEREFORE, the parties hereto agree as follows: Agreement THIS INDEPENDENT CONTRACTOR SERVICES AGREEMENT (this Agreement ) is made this day of, 20 (the Effective Date ), regardless of the date of execution, by and between Sierra Field Services, Inc., a Nevada

More information

STREET ADDRESS: 3250 GREY HAWK CT., CARLSBAD, CA 92010 PHONE: 760-599-7242 *FAX:

STREET ADDRESS: 3250 GREY HAWK CT., CARLSBAD, CA 92010 PHONE: 760-599-7242 *FAX: Dear Producer: SafeBuilt Insurance Services, Inc. (SIS), DBA: Structural Insurance Services (SIS) looks forward to doing business with your agency and beginning a good working relationship. CHECKLIST Legible

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the Agreement ), is made effective as of the sign up date on the login information page of the CarePICS.com website, by and between CarePICS,

More information

CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions

CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions CONTRACTOR PACKET Vendor Invoice and Payment Processing Instructions Introduction Cummings Property Management Inc. is the company that manages the administrative and financial operations of the community

More information

TEXAS FAIR PLAN PRODUCER REQUIREMENTS AND PERFORMANCE STANDARDS

TEXAS FAIR PLAN PRODUCER REQUIREMENTS AND PERFORMANCE STANDARDS Producer Requirements Page 1 TEXAS FAIR PLAN PRODUCER REQUIREMENTS AND PERFORMANCE STANDARDS The following Texas FAIR Plan Association ( Association ) requirements and producer performance standards (

More information

Vendor Registration 6103 W. Montrose Avenue, Chicago, IL 60634 p: 773.647.1992 f: 773.751.5057 www.evaluationzone.com

Vendor Registration 6103 W. Montrose Avenue, Chicago, IL 60634 p: 773.647.1992 f: 773.751.5057 www.evaluationzone.com Vendor Registration Thank you for your interest in becoming an approved appraisal provider for evaluation ZONE, Inc. (eval). For your review, we have attached our standard appraiser approval package, which

More information

CLS Investments, LLC Instructions for the Solicitor Application and Agreement

CLS Investments, LLC Instructions for the Solicitor Application and Agreement CLS Investments, LLC Instructions for the Solicitor Application and Agreement Please complete all fields on page 1 of the Solicitor Application and Agreement. Some general guidelines are set forth below.

More information

Feel free to call us if you have any questions. Again, thank you for your interest in Maverick Logistics.

Feel free to call us if you have any questions. Again, thank you for your interest in Maverick Logistics. Dear Carrier, Thank you for your interest in becoming a carrier for Maverick Logistics, LLC. We offer excellent opportunities through competitive rates, prompt settlements, and an experienced staff. To

More information

CONSULTING SERVICES AGREEMENT THE CORPORATION OF THE CITY OF GUELPH, an Ontario municipality. ( City ) and. an Ontario. ( Consultant").

CONSULTING SERVICES AGREEMENT THE CORPORATION OF THE CITY OF GUELPH, an Ontario municipality. ( City ) and. an Ontario. ( Consultant). Page 1 of 13 CONSULTING SERVICES AGREEMENT This consulting services agreement is between: THE CORPORATION OF THE CITY OF GUELPH, an Ontario municipality ( City ) and, an Ontario ( Consultant"). The parties

More information

SHIPPER requires transportation of the commodities from and to the points described in this Contract.

SHIPPER requires transportation of the commodities from and to the points described in this Contract. FREIGHT FORWARDING CONTRACT This Agreement is entered on between AIR GROUND LOGISTICS, INC. (referred to as "AIR GROUND"), an Illinois corporation whose address is 754 Foster Ave., Bensenville, Illinois

More information

Independent Agent Agreement

Independent Agent Agreement Independent Agent Agreement This Independent Agent Agreement ("Agreement ) is dated as of the date set forth on the signature page to this Agreement (the Effective Date ), by and between Customized Trucking

More information

LTC ELITE, LLC MEMBERSHIP AGREEMENT

LTC ELITE, LLC MEMBERSHIP AGREEMENT LTC ELITE, LLC MEMBERSHIP AGREEMENT This Membership Agreement (this Agreement ) is made and entered into effective, (the Effective Date ), by and between LTC Elite, LLC, a Texas limited liability company

More information

New Carrier Setup Form

New Carrier Setup Form New Carrier Setup Form Carrier Name: Business Address Street: City: State: Zip: Contact Name: Phone Number: Cell Phone Number: Toll Free Phone Number: Fax Number: Email Address: Payee Address (if different)

More information

KRONOS CANADA, INC. TERMS AND CONDITIONS OF SALE

KRONOS CANADA, INC. TERMS AND CONDITIONS OF SALE KRONOS CANADA, INC. TERMS AND CONDITIONS OF SALE 1. Terms; Acceptance; Other Documents These terms and conditions (this Agreement ) contains the terms and conditions that apply to all purchases of products

More information

SLM BROKERS 11441 GEHR RD WAYNESBORO PA 17268 PHONE: 717-762-2772 FAX: 717-762-0953

SLM BROKERS 11441 GEHR RD WAYNESBORO PA 17268 PHONE: 717-762-2772 FAX: 717-762-0953 SLM BROKERS 11441 GEHR RD WAYNESBORO PA 17268 PHONE: 717-762-2772 FAX: 717-762-0953 In order to get you set up with our company we will need the following documents: Copy of your operating authority Copy

More information

American Transport Group, LLC. Respect and commitment guaranteed. Informational Packet

American Transport Group, LLC. Respect and commitment guaranteed. Informational Packet American Transport Group, LLC Respect and commitment guaranteed. About Us Here at American Transport Group, LLC our Carriers are our customers, treated with respect. ATG works for you, helping make your

More information

INSURANCE AGENCY AGREEMENT

INSURANCE AGENCY AGREEMENT INSURANCE AGENCY AGREEMENT BritAmerica Management Group, Inc., hereinafter referred to as the Company, hereby appoints: Agent Agency Address City State Zip Tax ID hereinafter referred to as the Agent.

More information

ELECTRONIC INDEPENDENT CONTRACTOR AGREEMENT INTRODUCTION

ELECTRONIC INDEPENDENT CONTRACTOR AGREEMENT INTRODUCTION INTRODUCTION This is an AGREEMENT between you and Field Solutions, LLC ( Field Solutions ) that defines the terms and conditions for Field Solutions to engage you to provide services to our customers as

More information

Truck Based Transportation will need the following list of items to add you to our list of approved carriers.

Truck Based Transportation will need the following list of items to add you to our list of approved carriers. Prospective Carrier, Truck Based Transportation will need the following list of items to add you to our list of approved carriers. Please return the following information in person, fax or mail in order

More information

COMPUTER SERVICES AGREEMENT

COMPUTER SERVICES AGREEMENT COMPUTER SERVICES AGREEMENT This COMPUTER SERVICES AGREEMENT ( "Agreement") is made and entered into effective as of the 1 day of January, 2008 (the Effective Date ), by and between 3T Productions, Inc.,

More information

BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT

BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT This BUSINESS ASSOCIATE AGREEMENT ( Agreement ) dated as of the signature below, (the Effective Date ), is entered into by and between the signing organization

More information

FREIGHT FORWARDER/CARRIER AGREEMENT

FREIGHT FORWARDER/CARRIER AGREEMENT FREIGHT FORWARDER/CARRIER AGREEMENT THIS AGREEMENT is made and entered into as of the day of, 20, by and between FXE Warehouse, LLC d/b/a Redwood Distribution ( FORWARDER ) and ( CARRIER ) (collectively,

More information

MOTOR CARRIER DATA SHEET. City State Zip. City State Zip. Select Payment Terms 21 Days 14 Days 7 Days 1 Day Terms & Fees Attached

MOTOR CARRIER DATA SHEET. City State Zip. City State Zip. Select Payment Terms 21 Days 14 Days 7 Days 1 Day Terms & Fees Attached RETURN COMPLETED PACKET TO YOUR BRIDGESTAR AGENT Welcome to Bridgestar Logistics! Please provide the requested information so your account profile can be established and/or updated, freight tendered and

More information

GOODS AND SERVICES AGREEMENT BETWEEN SOUTHERN CALIFORNIA PUBLIC POWER AUTHORITY AND COMPANY/CONTRACTOR NAME

GOODS AND SERVICES AGREEMENT BETWEEN SOUTHERN CALIFORNIA PUBLIC POWER AUTHORITY AND COMPANY/CONTRACTOR NAME GOODS AND SERVICES AGREEMENT BETWEEN SOUTHERN CALIFORNIA PUBLIC POWER AUTHORITY AND COMPANY/CONTRACTOR NAME This GOODS AND SERVICES AGREEMENT ("Agreement") is entered into and effective [DATE], by and

More information

Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0

Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0 Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0 This Sales Agent Agreement (the Agreement ) is made and effective as of this the day of 13 by and between

More information

NATIONAL CONTRACTORS INSURANCE COMPANY, INC., A RISK RETENTION GROUP SUBSCRIPTION AND SHAREHOLDERS AGREEMENT

NATIONAL CONTRACTORS INSURANCE COMPANY, INC., A RISK RETENTION GROUP SUBSCRIPTION AND SHAREHOLDERS AGREEMENT 1 NATIONAL CONTRACTORS INSURANCE COMPANY, INC., A RISK RETENTION GROUP NOTICE SUBSCRIPTION AND SHAREHOLDERS AGREEMENT This policy is issued by your risk retention group. Your risk retention group may not

More information

TERMS OF BUSINESS AGREEMENT

TERMS OF BUSINESS AGREEMENT TERMS OF BUSINESS AGREEMENT 2525 E Camelback Rd, Suite 800 As used in this Agreement, The Keating Group, Inc. (tkg) shall refer to any business unit or entity that may be affiliated through common ownership

More information

TRANSPORTATION SERVICES AGREEMENT

TRANSPORTATION SERVICES AGREEMENT TRANSPORTATION SERVICES AGREEMENT This Transportation Services Agreement (the AGREEMENT") is entered into by ( Customer ) and between Company shall mean RSI Relo, Inc., Relocation Services International,

More information

INDEPENDENT CONTRACTOR AGREEMENT (ICA)

INDEPENDENT CONTRACTOR AGREEMENT (ICA) INDEPENDENT CONTRACTOR AGREEMENT (ICA) (This agreement is not a construction contract within the meaning of Civil Code section 2783, and is not an agreement for the provision of construction services within

More information

Carrier Certification Requirements Sheet

Carrier Certification Requirements Sheet Carrier Certification Requirements Sheet KLLM Logistics Services welcomes your interest in becoming an approved carrier. We are confident that you will find KLLM Logistics Services a company that is dedicated

More information

Kirsch Transportation Services, Inc. 25 Main Place, Suite 300 Council Bluffs, IA 51503 Fax: (712) 256-0843 Phone: (877) 341-9611

Kirsch Transportation Services, Inc. 25 Main Place, Suite 300 Council Bluffs, IA 51503 Fax: (712) 256-0843 Phone: (877) 341-9611 Kirsch Transportation Services, Inc. 25 Main Place, Suite 300 Council Bluffs, IA 51503 Fax: (712) 256-0843 Phone: (877) 341-9611 Kirsch Transportation, Inc. ( Kirsch ) is excited to begin new relationships

More information

Lipman Logistics Services LLC would like to add your company to our growing list of active, approved brokers.

Lipman Logistics Services LLC would like to add your company to our growing list of active, approved brokers. Dear Contract Broker, Lipman Logistics Services LLC would like to add your company to our growing list of active, approved brokers. Please return the following documents by fax, email, or mail to be placed

More information

W-9: Please fill out. The IRS requires that we keep a W-9 form on file for whomever we do business with.

W-9: Please fill out. The IRS requires that we keep a W-9 form on file for whomever we do business with. Dear Authorized Independent Contractor, Thank you for your desire to work with Gorilla Capital, Inc. and welcome! We invite you to take advantage of our website www.gorillacapital.com, as it will give

More information

PURCHASE ORDER TERMS AND CONDITIONS

PURCHASE ORDER TERMS AND CONDITIONS PURCHASE ORDER TERMS AND CONDITIONS This purchase order is subject to the following terms and conditions. The terms and conditions herein set forth constitute an offer by Purchaser and may be accepted

More information

Following is a copy of our Broker-Carrier Agreement, brokerage license, surety bond, and IRS Form W-9.

Following is a copy of our Broker-Carrier Agreement, brokerage license, surety bond, and IRS Form W-9. MIDWEST COAST LOGISTICS, LLC PO BOX 5233 1600 E BENSON RD SIOUX FALLS, SD 57117-5233 Following is a copy of our Broker-Carrier Agreement, brokerage license, surety bond, and IRS Form W-9. Please fill out

More information

Agent Agreement WITNESSETH

Agent Agreement WITNESSETH PATRIOT NATIONAL UNDERWRITERS, INC. Agent Agreement THIS AGENT AGREEMENT (the Agreement ) is made and entered into by and between Patriot National Underwriters, Inc., a Texas corporation ( Patriot ), and

More information

Please fill out this form and email to dispatch@esptrans.com or fax to 888-693-0392. Full Company Name: Carrier Contact Name: Carrier Phone Number :

Please fill out this form and email to dispatch@esptrans.com or fax to 888-693-0392. Full Company Name: Carrier Contact Name: Carrier Phone Number : Please fill out this form and email to dispatch@esptrans.com or fax to 888-693-0392 Full Company Name: Carrier Contact Name: Carrier Phone Number : Carrier Fax Number: Carrier Email Address: Remit Address

More information

CONTRACT CARRIER TRANSPORTATION AGREEMENT

CONTRACT CARRIER TRANSPORTATION AGREEMENT CONTRACT CARRIER TRANSPORTATION AGREEMENT THIS AGREEMENT is made and entered on, by and between Acuity Specialty Products, Inc., a wholly-owned subsidiary of Acuity Brands, Inc., d/b/a ZEP Manufacturing,

More information

CALIFORNIA PRODUCER APPOINTMENT PACKAGE

CALIFORNIA PRODUCER APPOINTMENT PACKAGE CALIFORNIA PRODUCER APPOINTMENT PACKAGE Please complete the attached application in its entirety and submit it Multi-State Insurance Services, Inc. via one of the options listed below: Mail: E-Mail: Multi-State

More information

Collection Escrow Instructions

Collection Escrow Instructions Collection Account No. Payee/Seller Name: Address: Telephone No. Email: To: Attn: Collection Escrow Instructions Escrow No. Obligor/Buyer Name: Address: Telephone No. Email: Pacific Trust Deed Servicing

More information

PRIEFERT LOGISTICS, LP CONTRACTOR LEASE AGREEMENT

PRIEFERT LOGISTICS, LP CONTRACTOR LEASE AGREEMENT PRIEFERT LOGISTICS, LP CONTRACTOR LEASE AGREEMENT (49 C.F.R. Part 376) This Agreement is effective as of this day of, 20, at (am/pm) by and between, referred to hereafter as Contractor, located at, (Street),,,

More information

RETURN ALL CARRIER SET UP PAPERWORK TO FAX: (888)367-7595

RETURN ALL CARRIER SET UP PAPERWORK TO FAX: (888)367-7595 1302 24th Street West, Suite 305 Tel: (888) 228-1055 - Fax: (888) 367-7595 www.bigskytransport.com Dear Carrier Partner Big Sky Transportation, LLC an established freight brokerage and logistics provider

More information

Duns #: 828202981 SCAC: KAMW. Kam-Way Corporate Office

Duns #: 828202981 SCAC: KAMW. Kam-Way Corporate Office Company Profile Business Name: Kam-Way Transportation, Inc. 215 Marine Drive, Suite 200 Blaine, WA 98230 Phone Number: (360) 332-1444 Fax Number: (360) 332-1222 Web: www.kam-way.com Established: April

More information

CONSULTANT AGREEMENT

CONSULTANT AGREEMENT Douglas County School District Re.1 Castle Rock, Colorado CONSULTANT AGREEMENT This agreement, dated effective as of is made and entered into by and between the Douglas County School District Re.1, Douglas

More information

P.O. Box 540547 Dallas, TX 75354 Phone: 214-631-3080 www.summittransportation.com. To: New Carrier Set Up From: Summit Transportation, Inc.

P.O. Box 540547 Dallas, TX 75354 Phone: 214-631-3080 www.summittransportation.com. To: New Carrier Set Up From: Summit Transportation, Inc. P.O. Box 540547 Dallas, TX 75354 Phone: 214-631-3080 www.summittransportation.com To: New Carrier Set Up From: Summit Transportation, Inc. Date: Today Fax: SEE BELOW Re: Carrier set up packet Pages: 16

More information

Purchase Order Addendum

Purchase Order Addendum [STANDARD TERMS AND CONDITIONS] Purchase Order Addendum This purchase order addendum sets forth the terms and conditions under which an offer is issued to the Seller by the Board of Regents of the University

More information

TRANSPORTATION BROKER AGREEMENT

TRANSPORTATION BROKER AGREEMENT TRANSPORTATION BROKER AGREEMENT THIS AGREEMENT entered into this day of, 2008 between MID-X Corp. hereinafter referred to as Broker, and, hereinafter referred to as Carrier. RECITALS: A. Broker is duly

More information

HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY

HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY This Agreement is made and entered into effective as of October

More information

Services Agreement Instruction Sheet

Services Agreement Instruction Sheet Delta-T Group POB 884 Bryn Mawr, PA 19010 Phone: 800-251-8501 FAX: 610-527-9547 www.delta-tgroup.com Services Agreement Instruction Sheet We thank you for your interest in Delta-T Group. Below please find

More information

Enclosed you will find our carrier set-up packet along with our company information. Included in the packet are:

Enclosed you will find our carrier set-up packet along with our company information. Included in the packet are: I want to thank you for your interest in RWI. At RWI, we pride ourselves in a culture of service where we value, anticipate and exceed our customers expectations. We also believe this type of service cannot

More information

Federated National Underwriters Phone: (800) 293-2532 (option 4) 14050 N.W. 14 th Street, Suite 180 Fax: (954) 308-1397

Federated National Underwriters Phone: (800) 293-2532 (option 4) 14050 N.W. 14 th Street, Suite 180 Fax: (954) 308-1397 AGENCY QUESTIONNAIRE Thank you for your interest in Federated National Underwriters representing Federated National Insurance Company and other nationally recognized insurance companies. Please complete

More information

INVESTMENT ADVISORY AGREEMENT

INVESTMENT ADVISORY AGREEMENT INVESTMENT ADVISORY AGREEMENT THIS AGREEMENT, entered into as of the day of, 20 (the Agreement ), by and between Brazos County, Texas (hereinafter the Client ) and PFM ASSET MANAGEMENT LLC, a Delaware

More information