Independent Delivery Driver Application

Independent Delivery Driver Application

For Urban Eatz Delivery 9801 Westheimer Rd. Suit 300 Houston TX 281-214-0404
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
E-mail *
Social Security # *
Dater of Birth *
Vehicle Type *
Select closest match.
What date can you start? *

Month Day Year
What is your availability?
Monday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Tuesday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Wednesday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Thursday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Friday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Saturday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Sunday

: Hour Minutes AM/PM Option
Until
until : Hour Minutes AM/PM Option
Is there a preferred side of area you would like to work? If so, what area?
This contract, when signed by both parties, is anagreement between an independent contract delivery person (Driver) and Urban Eatz Delivery. Driver acepts the following requirements as the minimum acceptable conditions of agreement:

(1)Driver does posses a valid driver's license.

(2)Driver provides a fully insured vehicle with valid registration and inspection.

(3)Driver accepts full accident liabitlity for personal injury and vehicular damage.

(4)Driver accepts full responsibility for any traffic violations.

(5)Driver will attempt to delivery all items in as close condition as possible as they left the restaurant.

(6)ABSOLUTELY NO SMOKING IN VEHICLE.

(7)Driver accepts full responsibility for the care and condition of any Urban Eatz Delivery owned equipment supplied to driver for use while performing contracted deliveries.
Have you been convicted of a felony in the last 3 years? If so, explain in the interview. (A conviction does not automatically disqualify you from employment. They will be judged on a case by case basis.) *
Driver's License Number *
Insurance Provider *
Insurance Provider phone number *
Policy Number *
Urban Eatz Delivery and Driver accept the following conditions of compensation:

(1)Daily pay (bank account is required)

(2)Compensation minimum of $4.10 for each delivery and 100% of all tips.

(3)It is hereby acknowledged that Urban Eatz Delivery is not liable for personal injury or vehicular damage incurred while Driver is performing duties as a contract delivery person.
Date that you are signing this document. *

Month Day Year
Required Signature *

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Managers Signature

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