Checklist DATE CARRIER NAME. Signed Transportation Agreement. W-9 Form (or W-8 if a foreign carrier) Completed Carrier Profile Form

Transcription

1 Checklist CARRIER DATE Signed Transportation Agreement W-9 Form (or W-8 if a foreign carrier) Completed Carrier Profile Form Copy of Carrier Operating Authority HazMat Certificate (if certified) Certificate of Insurance evidencing Worker s Compensation Coverage Completed Worker s Compensation Hold Harmless Letter Insurance certificate naming WorldWide Logistics as a certificate holder with a 30-day cancellation notice If using a factor, please provide a Notice of Assignment Please return all information to the following address: th Street Urbandale, IA Fax number (515) carriersetup@worldwide-logistics.com

2 Worker s Compensation Hold Harmless Letter agrees to hold harmless and indemnify WorldWide Logistics Inc. and any of its affiliates against any award by a Worker s Compensation Court, similar administrative body, or court of law. Authorized Carrier Signature Title Address City, State, Zip Date

3 Certificate of Insurance Request Form DATE TOTAL PAGE ED (including this page) INSURANCE COMPANY INFORMATION INSURANCE CO. CONTACT ADDRESS CITY STATE ZIP CODE NUMBER NUMBER IF TWO, SECOND INSURANCE CARRIER INFORMATION INSURANCE CO. CONTACT ADDRESS CITY STATE ZIP CODE NUMBER NUMBER CARRIER INFORMATION CARRIER CONTACT ADDRESS CITY STATE ZIP CODE NUMBER NUMBER WorldWide Logistics is requesting a copy of certificate of insurance covering Liability, Cargo, and Workmen s Compensation regarding the above named Insured be issued with the following special conditions: Certificate Holder s Name: th Street Urbandale, IA Certificate of Insurance must show a 30-day written cancellation notice. Please the certificate to carriersetup@worldwide-logistics.com or fax to If you have any questions, please contact Carrier Development at Thank you in advance for your quick reply.

4 Insurance Certificate WorldWide requires all carriers to have a certificate of insurance for Liability and Cargo insurance issued to WorldWide as the certificate holder, and with a 30-day cancellation notice. Liability insurance value not less than $1,000,000. Cargo insurance value not less than $100,000. IF THERE IS A RIDER ON THE CARGO, PLEASE INCLUDE. Also include your Workmen s Compensation on the certificate. The insurance certificate holder information: th Street Urbandale, IA Please have your insurance carrier the certificate to carriersetup@worldwide-logistics.com or fax to Carrier Billing Information All shipments are to be billed to: th Street Urbandale, IA Phone number (515) Fax number (515) Billing@worldwide-logistics.com Carrier Payment Status Carrier Development Phone number (515) Fax number (515) carrierpayables@worldwide-logistics.com Quickpay Please discuss terms and requirements with your Logistics Account Manager. Checks are mailed 7 days from receipt of required paperwork.

5 Carrier Profile Form Both pages must be completed and returned. CARRIER WEBSITE FEDERAL TAX IDENFICATION # FEDERAL TAX CLASSIFICATION: SOLE PROPRIETOR( ) C-CORP( ) S-CORP( ) PARTNERSHIP( ) LLC( ) IF LLC and TAX CLASSIFICATION: C-CORP( ) S-CORP( ) PARTNERSHIP( ) IF LLC and INDIVIDUAL/SOLE PROPRIETOR( ), PROVIDE OWNERS PHYSICAL ADDRESS CITY STATE ZIP CODE COUNTY MAILING ADDRESS, if different CITY STATE ZIP CODE NUMBER ACCOUNT RECEIVABLE CONTACT FACTOR NUMBER NUMBER FACTOR NUMBER INSURANCE COMPANY INS. NUMBER INS. NUMBER US DOT # MC# SCAC CODE STATE OF OPERATION ARE YOU A MINORITY CARRIER? DO YOU HAVE: CANADIAN AUTHORITY? MEXICAN AUTHORITIES? EDI CAPABILITIES? HAZMAT? TEAM DRIVER? TWIC? SMARTWAY #? GTPAT? EQUIPMENT COUNTS: POWER UNITS? OPEN FLATS? SIDE KITS? CONESTOGAS? VAN? OTHER? DO YOU HAVE: 4 TARPS? 6 TARPS? 8 TARPS? OTHER TARPS? WHAT IS YOUR PAYLOAD CAPACITY? LBS MAXIMUM BUNDLE SIZE?

6 Carrier Profile Form (page 2) LOAD CONFIRMATION (responsible for communicating with drivers for load assignments) CONTACT 1 (First & Last Names Required) CONTACT 2 PROOF OF DELIVERY (responsible for shipment documents) CONTACT 1 Check if the same as above ( ) CONTACT 2 AFTER HOURS (responsible for addressing shipment issue after normal business hours) CONTACT 1 Check if the same as above ( ) CONTACT 2 INSURANCE (responsible for insurance coverage and information at your company) CONTACT 1 Check if the same as above ( ) CONTACT 2 INSURANCE CARRIER INSURANCE

7 Carrier Profile Form (page 3) CLAIMS (responsible for cargo claims) CONTACT 1 Check if the same as above ( ) CONTACT 2 NON-COMPLIANCE (responsible for addressing shipment issues) / CARRIER SCORECARD CONTACT 1 Check if the same as above ( ) CONTACT 2 CARRIER SERVICE AREAS (Optional) All 48 contiguous states Canada Mexico OR (Check states and countries that apply) AL AZ AR CA CO CT DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

8 Agreement Number: Transportation Agreement This Agreement is made and entered into on, by and between ( WorldWide ), a Federally licensed property broker operating under Federal Identification Number MC and ( Carrier ) Operating under US DOT Number. 1. Term Subject to Section 2 herein, the Term of this Agreement shall be for one (1) year and shall automatically renew for a successive one (1) year period; provided, however, that this Agreement may be terminated, by either party, at any time by giving thirty (30) days prior written notice, unless otherwise specified herein. If any shipment within the scope of the services provided by WorldWide and Carrier remains in transit on the effective date of a termination of this Agreement, the rights and duties of WorldWide and Carrier shall remain in effect with respect to such shipment until it is delivered and all related invoices and claims are satisfied. 2. Carrier s Representations, Operating Authority, and Compliance with the Law Carrier represents and warrants that it is duly and legally qualified to provide the transportation services contemplated herein, and Carrier agrees to comply with all Federal, State and local laws regarding the provision of such services. Carrier represents and warrants that it is a Federally Licensed Motor Carrier of property providing transportation by motor vehicle for compensation as defined under 49 USC 13102(4)(B). In accordance with Federal law, Carrier assumes complete responsibility for the maintenance and safe operation of equipment under its Federal operating license and WorldWide assumes no responsibility for the operation of equipment, and has no control over, or right to control, the operation of the equipment. Under no circumstance, however, shall Carrier render services pursuant to this Agreement beyond the scope of its Federally Licensed authority and/or in a manner that is not in compliance with all Federal, State and local laws pertaining to the providing of transportation services as a motor carrier. Carrier represents and warrants that it has complete responsibility for the selection, retention, hiring, and firing of drivers, and WorldWide assumes no responsibility for such activities. Further, Carrier agrees that WorldWide has no control over these activities and shall have no right to control such activities. Carrier represents and warrants that it will transport property under this Agreement pursuant to its own operating authority and will not re-broker, assign, or interline the shipments made pursuant to this Agreement, without prior written consent of WorldWide. If Carrier breaches this provision, WorldWide shall have the right of paying the monies it owes Carrier directly to the delivering carrier, in lieu of payment to Carrier and Carrier will not be released from any liability and damages (including consequential damages) to WorldWide under this Agreement. Carrier further represents that it does not have an Unsatisfactory safety rating issued by the Federal Motor Carrier Safety Administration ( FMCSA ) and will notify WorldWide in writing immediately if its safety rating is changed to Unsatisfactory or Conditional, or if its operating authority is revoked, suspended or rendered inactive for any reason. WorldWide shall have the right to immediately terminate this Transportation Agreement upon receipt of any knowledge that the Carrier has an Unsatisfactory or Conditional safety rating, or if its operating authority is revoked, suspended or rendered inactive for any reason. Carrier represents and warrants that it agrees that if any person or entity involved in a shipment of property pursuant to this Agreement inserts WorldWide s name as a carrier on a bill of lading that this shall be understood as being for the convenience only of the shipper or other person or entity involved in the shipment and shall not change WorldWide s status as a property broker nor Carrier s status as a motor carrier. Initial

9 Carrier represents and warrants that it shall be responsible for ensuring compliance with all customs and security laws that are applicable to motor carriers transporting goods either domestically in the United States or for import to or export from the United States. 3. Specified Services Carrier s services under this Agreement are specifically designed to meet the distinct needs of WorldWide s customers and consignees under specified rates and conditions set forth herein. A. Carrier agrees to: abide by any rules and regulations set forth by each of WorldWide s customers and consignees, including but not limited to; required safety equipment; check in responsibilities and personnel conduct; enter accurate delivery information on the WorldWide website within two (2) hours of either delivery appointment or if no delivery appointment within two (2) hours of consignees end delivery window. (End delivery window is defined as the last receiving hour of the consignee. If a consignee is a 24 hour shipper, delivery information must be entered by 02:00am); provide to WorldWide updates on in-transit status as required by each WorldWide customer; enter any information relating to product damage, shortages or overages on the WorldWide website in a prompt manner. WorldWide s receipt of pick-up and delivery information, and product damage, shortage, and overage is for its informational purposes only so that WorldWide can facilitate the transfer of information between entities and persons involved in the shipment of property, including, shippers, consignors, and consignees in a timely manner. 4. Receipts and Bills of Lading Each shipment hereunder shall be evidenced by a receipt in such form as specified by WorldWide or, alternatively, by a WorldWide customer, signed by Carrier showing the kind and quantity of product received by Carrier at origin. The absence or loss of any such receipt shall not relieve Carrier of its obligations and responsibilities with respect to any shipment made hereunder. Such receipt shall be prima facia evidence of receipt of such shipment in good order and condition unless otherwise noted on the face of such receipt by Carrier. Upon delivery of each shipment made hereunder, Carrier shall obtain a receipt showing the kind and quantity of product delivered to the consignee of such shipment at the destination specified by WorldWide, and Carrier shall cause such receipt to be signed by the consignee. Any terms, conditions and provisions of the bill of lading, manifest or other form of receipt or contract shall be subject and subordinate to the terms, conditions and provisions of the Agreement to the extent such terms relate to the duties, rights and liabilities of WorldWide and Carrier under this Agreement. Carrier shall notify WorldWide immediately of any exception made on the bill of lading, manifest or other receipt. WorldWide s receipt of exceptions on a bill of lading, manifest or other receipt is for its informational purposes only so that WorldWide can facilitate the transfer of information between shippers, consignors, and consignees in a timely manner. 5. Carrier Paper Work Management Carrier agrees to store all applicable paperwork (bills of lading, receipts, manifests, contracts) as noted above, for a period of not less than three (3) years from date of delivery. Carrier further agrees to make said paperwork available to WorldWide upon twenty-four (24) hour notice of request for paperwork. WorldWide shall send a written request for paperwork with bill of lading reference number and Carrier shall promptly return requested paperwork. WorldWide s receipt of any paperwork is for its informational purposes and convenience only so that WorldWide can facilitate the transfer of information regarding shipments and claims between shippers, consignors, and consignees in a timely manner. 6. Carrier Operations as an Independent Contractor Carrier shall, at its sole cost and expense: A. Furnish all equipment necessary or required for the performance of its obligations hereunder (the Equipment ); B. Pay all expenses related, in any way, with the use and operation of the Equipment, including but not limited to local, state and federal payroll taxes; driver wages, salaries, and commissions; fees for unemployment insurance and workers compensation insurance; pensions; and any other social security or related protection with respect to persons engaged by Carrier; C. Maintain the Equipment in good repair, mechanical condition and appearance; D. Utilize only competent, able and legally licensed personnel. Carrier shall have full control of such personnel and shall perform the services hereunder as an independent contractor. In this regard, the Carrier agrees to undertake the job of Initial

10 transporting property arranged by WorldWide and WorldWide s sole interest is in achieving the result of tendering freight to Motor Carriers to effectuate delivery. Carrier is solely responsible for managing its operations, employees, and agents so as to operate within all applicable Federal, State, and Local regulatory requirements to ensure the safe operation of Carrier s vehicles, drivers, and facilities. WorldWide has no control or right to control the Carrier s operations and does not have control over, nor has the right to control, the means, method, and manner by which the Carrier transports property. 7. Indemnity Carrier shall defend, indemnify, and hold harmless WorldWide from and against all loss, damage, expense, cost, including reasonable attorney fees, fines, actions and claims for bodily injury to persons (including death) and for damage to property, including cargo loss, arising out of or in connection with Carrier s failure to comply with the terms of this Agreement, or caused by Carrier s loading, handling, transportation, driving, unloading or delivery of any shipments made hereunder. 8. Insurance Carrier shall procure and maintain, at its sole cost and expense, insurance with a reputable and financially responsible insurance carrier insuring Carrier against: A. Motor Carrier liability for personal injury (including death) and property damage in an amount not less than $1,000, per occurrence; B. Freight loss or damage in any amount not less than $100, per occurrence. C. Worker s compensation in any amount not less than $500, limit: 1) In the event that Carrier is qualified to be covered by country/province/state s workers compensation, Carrier shall provide written documentation of that qualification and coverage, including any maximum coverage amounts. D. Any additional insurance that may be required by applicable law. Carrier will cause WorldWide to be named as a named additional insured, and certificate holder on the Motor Carrier liability and cargo insurance issued to the Carrier and shall furnish to WorldWide written Additional Insured Endorsements obtained from the insurance carrier and certificates of insurance showing that such insurance has been procured, is being properly maintained, the expiration date, and specifying that written notice of cancellation or modification of the policies shall be given to WorldWide at least thirty (30) days prior to such cancellation or modification. Upon written request, Carrier shall within (14) days of such request provide WorldWide with copies of the applicable insurance policies, forms, and endorsements. 9. Freight Loss, Damage or Delay If WorldWide is provided notice of a claim, it shall submit to Carrier written notice of the claim, including losses or expenses resulting from Carrier s delay in providing service, within nine (9) months of the delivery date of this shipment, or, if no delivery, the date of the occurrence resulting in the claim. WorldWide will supply information regarding a cargo claim to Carrier to facilitate the flow of information regarding the claim and its resolution. The filing, processing and disposition of all cargo claims shall be governed by 49 C.F.R et. seq. and 49 C.F.R et. seq. Carrier shall be liable to WorldWide s customer, consignee, or consignor for cargo claims occurring while in the possession or under the control of Carrier, relating to or arising out of Carrier s negligent performance of or failure to properly perform the transportation services provided for in this Agreement. If WorldWide is caused to pay its customer, consignee, or consignor to resolve a cargo claim prior to Carrier issuing such payment to the customer, consignee, or consignor, then Carrier shall fully indemnify WorldWide for the payment of such claim pursuant to the Paragraph 7 of this Agreement. Carrier further agrees that if WorldWide is caused to pay the shipper, customer, consignee, or consignor to resolve a cargo claim that WorldWide shall automatically receive an assignment the claim from the shipper, customer, consignee, or consignor. Neither WorldWide nor Carrier shall be liable to the other for any loss, damage, delay or failure to perform caused by acts of God, public enemy, inherent nature of the cargo, wars, strikes, fires or floods. Carrier shall be liable to WorldWide s customer, consignee, or consignor for all economic loss, including consequential damages that are incurred for any freight loss, damage or delay claim. 10. Waiver of Carrier s Lien Initial

11 Carrier shall not withhold any goods of a WorldWide customer on account of any dispute as to prices or any alleged failure of WorldWide to pay charges incurred under this Agreement. Carrier is relying upon the general credit of WorldWide and hereby waives and releases all liens which Carrier might otherwise have to any goods of WorldWide customers in the possession or control of Carrier. 11. Payments Upon Carrier s entry of delivery information, WorldWide will pay for transportation services performed under this Agreement the rates and charges as shown on the Schedule of Rates attached as Appendix A and any written supplements or revisions thereto signed and agreed to by Carrier and WorldWide. WorldWide will require Carrier to invoice WorldWide for line haul or accessorial charges. Payment by WorldWide will be made within net thirty (30) days from receipt of invoice, bill of lading, and proof of delivery information, except in the event that a Customer fails to pay all amounts due WorldWide for the load or loads transported. In no event shall WorldWide be liable for any transportation charges for which WorldWide did not have primary responsibility for payment under the circumstances surrounding the involved shipment. Carrier agrees that WorldWide is solely liable for all freight charges related to the transportation services provided herein, and, as such, Carrier agrees to refrain from all collection efforts against the shipper, receiver, consignor, consignee or the WorldWide customer. Carrier further agrees that WorldWide has the discretionary right to offset any payments owed to Carrier hereunder for liability incurred by Carrier pursuant to Section 9 of this Agreement. 12. Non-Solicitation of Brokered Customers Carrier will not solicit traffic from any shipper, consignor, consignee or customer of brokered loads where: A. The availability of traffic first became known to Carrier as a result of the brokered load; or B. The traffic of the shipper, consignor, consignee or customer of WorldWide was first tendered to Carrier by WorldWide. If Carrier breaches this Agreement and directly or indirectly solicits traffic from brokered customers of WorldWide and obtains traffic from such customer during the term of this Agreement for twelve (12) months thereafter, Carrier shall be obligated to pay WorldWide, for a period of fifteen (15) months thereafter, commission in the amount of twenty percent (20%) of the transportation revenue resulting from traffic transported for such customer, and Carrier shall provide WorldWide with all documentation requested by WorldWide to verify such transportation revenue. 13. Assignment/Modification/Benefit of Agreement This Agreement may not be assigned or transferred in whole or in part, and supersedes all other Agreements and all tariffs, rates, classifications and schedules published, filed or otherwise maintained by Carrier. This Agreement shall be binding upon and ensure to the benefit of the parties hereto. 14. Severability In the event that the operation of any portion of this Agreement results in a violation of any law, the parties agree that such portion shall be severable and that the remaining provisions of this Agreement shall continue in full force and effect. 15. Waiver Carrier and WorldWide expressly waive any and all rights and remedies allowed under 49 U.S.C to the extent that such rights and remedies conflict with this Agreement. Failure of WorldWide to insist upon Carrier s performance under this Agreement or to exercise any right or privilege shall not be a waiver of any of WorldWide s rights or privileges herein. 16. Dispute Resolution Any dispute which cannot be resolved by agreement of the parties shall be resolved by arbitration before a single arbitrator appointed by, and proceeding under the rules of the American Arbitration Association in Des Moines, IA. 17. No Creation of Partnership or Joint Venture Initial

12 None of the terms of this Agreement are intended to create or imply the creation of a Partnership or Joint Venture between WorldWide, Carrier, and any customer, consignee and any other entity. WorldWide and Carrier have elected to contract with each other as separate and distinct entities which do not have any shared control or interest in each other s operations, ownership, property, profits, and losses. 18. Entire Agreement Unless otherwise agreed in writing, this Agreement contains the entire understanding of the Parties and supersedes all verbal or written prior agreements, arrangements, and understandings of the Parties relating to the subject matter stated herein. The Parties further intend that this Agreement constitutes the complete and exclusive statement of its terms, and that no extrinsic evidence may be introduced to reform this Agreement in any judicial or arbitration proceeding involving this Agreement. 19. Counterparts This Agreement may be executed in any number of counterparts each of which shall be deemed to be a duplicate original hereof. 20. Notices All notices provided or required by this Agreement shall be made in writing and delivered, return receipt requested, to the addresses shown herein; or by electronic mail or facsimile (with confirmation of delivery). IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed in their respective names by their duly authorized representatives as of the date first written above. WORLDWIDE CARRIER : th Street, Urbandale, IA Address: Signature: Printed Name: Brandon Renshaw Title: Chief Financial Officer Date: Signature: Printed Name: Title: Date: MUST RETURN ALL PAGES OF CONTRACT TO BE SET UP Initial