Pro Load Hauler Dispatcher - Carrier Agreement Form

First Name

Last Name

Company Name

Address

Street Address

Address

Street Address Line 2

State / Province

City

Phone Number

Please enter a valid phone number.

Email

example@example.com

How did you hear about us

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MC

Equipment

Max Weight Limit

Truck/ trailer

Please list your securements (Tarps, Straps, Chains, lift gate, ramps, etc)

Insurance Information: Your agents PH #, Email (so we are able to attain your COI for your clients/brokers)

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Factoring Company Info: Your contacts info, Email and PH # (Please also state how we will vet credit on your clients/brokers) If you do not have a factoring, put N/A and we will refer you to our relationship with OTR Capital

Tell us about your yourself, your goals: IE Where do you see your company in the next 2 years, 5 years, etc

How often do you want to be home?

What areas will you drive?

Are you certified to carry loads that request OSHA, TWIC or HAZMAT Drivers? List any certifications or permits that you have along with their expiration dates.

Date

Are you certified to carry loads that request OSHA, TWIC or HAZMAT Drivers? List any certifications or permits that you have along with their expiration dates.

N

Will you be willing to recommend us?

YesMaybe

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Please give reference of any two people whom you feel would like our services

Full Name

Address

Contact Number

2

Driver's Name, Driver Cell # if you will not be driving

I agree to pay the Dispatching Fee: (Pro Load Hauler and you agreed to this fee amount, fee is 10%)

AGREE OR NOT AGREE

Hereinafter referred to as CARRIER. WHEREAS, DISPATCHER is a transportation dispatcher handling the necessary paperwork between a SHIPPERS and the CARRIER in order to secure “CARGO” for said

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

1. DISPATCHER agrees to handle paperwork, phone, fax calls to, from the SHIPPER/BROKER 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. 2. DISPATCHER bears no financial or legal responsibility in the transaction between the SHIPPER, CARRIER agreement. However, the DISPATCHER, upon receiving access to a CREDIT portal with their factoring company, will pre-vet all SHIPPERS/BROKERS on behalf of the CARRIER and give feedback if any issues arise.

1. CARRIER agrees to pay DISPATCHER of the face value AGREED DISPATCHER FEE of the contract between the SHIPPER, CARRIER as stated on the load confirmation sheet. Carrier further agrees to pay DISPATCHER at the time of securing cargo. 2. CARRIER gives DISPATCHER authority to provide his signature for rate confirmation sheets, invoices, and associated paperwork necessary for securing cargo and billing purposes. The terms of this agreement shall be perpetual, provided that either party may terminate. 3. SHIPPER agrees to pay CARRIER, following receipt of a freight bill and proof of delivery of each shipment to its assigned destination, free of damage or shortage. The amount to be paid by SHIPPER to CARRIER shall be established between parties on a per shipment basis prior to

4. CARRIER shall be liable for loss, damage, or liability occasioned by the transportation of property arranged by DISPATCHER, SHIPPER while in the possession of the carrier. 5. CARRIER agrees to hold DISPATCHER, SHIPPER harmless from any liability for personal injury or property damage occurring during an operation conducted by CARRIER pursuant to this agreement. 6. CARRIER will be responsible to comply with all applicable state and federal regulations pertaining to the operation of a motor carrier. 7. Carrier acknowledges that the customer information being provided by DISPATCHER is the sole and exclusive property of DISPATCHER and that neither it, nor any employee, agent, or subcontractor shall back-solicit, directly or indirectly, communicate or perform any service for compensations for any account of DISPATCHER which has previously tendered to CARRIER for transportation, nor shall it pass on or reveal any customer information obtained to any other person or company. 8. Solicitation prohibited under this AGREEMENT means participation in any conduct, whether direct or indirect, the purpose of which involves transportation and/or handling of property by CARRIER for which CARRIER does, or did in the past, provide such service for that customer under arrangements first made or procured by DISPATCHER. Solicitation includes conduct initiated or induced by CARRIER, or accepted by CARRIER, upon inducement by DISPATCHER efforts 9. CARRIER agrees that it will function under terms of this agreement strictly as duly permitted contract carrier, and hereby waves any and all rate provisions, which may be contained in its published carrier tariffs. 10. This agreement shall be deemed to be effective on the first date that CARRIER, DISPATCHER, and SHIPPER commence business together, and the parties hereby agree that the provisions herein properly express and memorialize the complete understanding as contained in any prior agreement either written or verbal

Date

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