5Eleven Logistics Form

Insta Forward Logistics Form
Date of Contract

MonthDayYear
DateHourMinutesAM/PM Option
CARRIER NAME
This Agreement is made on this Date of Service of form submitted by and between "Insta Forward Logistics" hereafter referred to as DISPATCHER and CARRIER. DISPATCHER is a transportation dispatcher handling the necessary paperwork between SHIPPERS and/or BROKERS and the CARRIER in order to secure "Freight" for said CARRIER.

WHEREAS, CARRIER is a Motor CONTRACT Carrier subject to the jurisdiction of the ICC: NOW THEREFORE, in consideration of the promises and covenants hereinafter contained it is mutually agreed by and between parties' hereto as follows:

OBLIGATIONS OF DISPATCHER

DISPATCHER agrees to handle paperwork, phone calls, and faxes from the BROKER or SHIPPER to tender commodities shipments to CARRIER for transportation in interstate commerce by CARRIER between points and places within the scope of CARRIER'S operating authority.

DISPATCHER bears no financial or legal responsibility in the transaction between the SHIPPER or Broker and you the CARRIER.

DISPATCHER will:
A. Make 100% effort to keep truck(s) loaded.

B. CARRIER will be contacted (by phone call/text/email) about EVERY load we find to offer and the driver will ACCEPT or REJECT the load.

C. Invoice the CARRIER at time of service; also provide a copy of each Load Confirmation Sheet.

D. Payment is due to DISPATCHER at time of invoice.

OBLIGATIONS OF DISPATCHER

Carrirer agrees to pay our negotiated fee. Which will be billed and due the day after delivery for the first load. After the first week, you will be invoiced once weekly, which the invoice will be sent out Friday, for all your weekly loads, and due Sunday.

CARRIER gives DISPATCHER authority to provide his signature for rate confirmation sheets, invoice and associated paperwork necessary for securing cargo and billing purposes. The terms of this Agreement shall be continuous, provided that either party may terminate same by giving 30 days written notice to the other.

CARRIER/COMPANY PROFILE FORM

Instructions: Please complete this form giving us all the information that pertains to you and your company. The better informed we are, the better we will be able to assist you. This form can be updated at any time by notifying us. This information is for our use only and will not be released to any third party without your express written permission.

PART I: CARRIER PROFILE INFORMATION SECTION
Negotiated fee
Our Negotiated fee
Email

Confirmation Emailexample@example.com
Contact Name

First NameLast Name
Office Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MC #
SSN/EIN #
DOT #
TWIC CERTIFIED:
HAZ MAT CERTIFIED:
PART 2: EQUIPMENT SECTION

(For more than one truck, use the multiple truck form)
VAN EQUIPMENT
Trailer Model Type/Number
Max Load Weight
HOTSHOT/Trailer Length
E-TRACK
VENTED
Logistics
Load Bars
Straps
HAZ MAT CERTIFIED:
AIRRIDE
Pads
Tarps
Comments
PART 3: FACTORING INFORMATION

If you use a factoring service, please provide us the following information. This will ensure that we only use brokers that are approved by your factoring company.
Factoring Company Name
Contact Name

First NameLast Name
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Website
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PART 4: INSURANCE INFORMATION

Please note: We do require our carriers to maintain a minimum of $1 Million in liability and $100,000.00 in Cargo Insurance.
Insurance Company
Policy Number
Agent Name

Area CodePhone Number
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Title:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PART 5: OTHER INFORMATION

Please use the following section to better describe your company with any information that we have not already asked for.
Additional Information
PART 6: CREDENTIALS & DOCUMENTS

We must have the following documents to start working for you. Please upload them here, or email or fax them to us separately.
1. A completed W9 Form.
2. A copy of your Motor Carrier Authority Form.
3. A copy of your Insurance Certificate
Touch Here to Upload Files

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Confirmation will be signed by CARRIER and electronically delivered to DISPATCHER. Payments are due to the DISPATCHER for services rendered and are not contingent on outstanding payments due to the CARRIER for loads that (s)he has hauled for the SHIPPER or BROKER.

Your electronic signature below confirms that you agree to the stated terms. Failure to pay the DISPATCHER for services rendered will result in immediate termination of contract and services unless otherwise determined by the DISPATCHER.

Insta Forward Logistics
By: Anthony Herod
Title: Owner/ C.E.O
Date: {dateOf}
Print Carrier Authorized Name
Title
Electronic Signature

Clear
LIMITED POWER OF ATTORNEY
This Limited Power of Attorney is made and entered into on by and between Insta Forward Logistics, a division of AMERATRANS, LLC, a Florida limited liability company (“Dispatcher”) and a Registered Motor Carrier with its principal office at , (“Carrier”); collectively referred to as the “Parties”.
The CARRIER hereby appoints and authorizes Insta Forward Logistics, to act and speak on its behalf as pertaining to: Professional Dispatch Services. Insta Forward Logistics shall have the power to:
- Contact shippers and brokers, negotiate rates, and procure agreed upon freight for carrier.
- Sign and execute broker contracts and rate confirmations for freight.
- Transfer paperwork as it pertains to each load (broker contracts, rate confirmations, BOLs, PODs, lumper receipts and any other relevant documents) to move cargo for shippers and/or brokers.
- Transfer company credentials (carrier profile, MC Certificate, W-9, certificate of insurance, and any other relevant documents) to move cargo for shippers and/or brokers.
- Submit load documents for payment (invoices, rate confirmations, BOLs, PODs, lumper receipts, and any other load documents) to shippers, brokers, and/or carrier’s current factoring company), if requested.
- Submit fuel advances, follow up on accounts receivable, make collection calls/emails, assist with claim resolutions, if requested.
- Request trip and oversize, overweight, and over-dimensional permits, if requested.
- Processing FMSCA documents (IFTA taxes, Form 2290, UCR, MCS-150, IRP, BOC3, compliance, safety audits etc.), if requested.
IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT on the date below and it shall remain in effect until terminated by either party.
Company Name
Printed Name
Title
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Insta Forward Logistics Form

PART 2: EQUIPMENT SECTION

PART 3: FACTORING INFORMATION

PART 4: INSURANCE INFORMATION

PART 5: OTHER INFORMATION

PART 6: CREDENTIALS & DOCUMENTS

LIMITED POWER OF ATTORNEY