2024 Carrier Package (Coastline Connect) Logo
  • Carrier Package

  • Thank you for your interest in being a carrier with Coastline Connect!

    Page 1: Contact Information

    Page 2: Broker-Carrier Agreement + Motor Carrier of Property Certificate of Compliance

    Page 3: Form W-9

    Page 4: Document Uploads*

     

    *Please be prepared to upload a copy of the following:

    1. Certificate of Insurance - General Liability $1,000,000
    2. Certificate of Insurance - Automobile Liability $1,000,000
    3. Certificate of Insurance - Cargo $100,000
    4. Certificate of Insurance - Workers Compensation $1,000,000 per occurrence (if applicable)
    5. Listing of equipment (tractors and trailers)
    6. DMV Registration for all listed trucks or trailers
    7. Air Resources Board Certificates for registered equipment
    8. Listing of authorized drivers
    9. Valid CA Commercial Driver's License for all authorized drivers
    10. Medical Examiner’s Certificate for all authorized drivers

     

    For any questions or concerns, please reach out to Sofia at coastlineconnectinc@gmail.com or call 805-790-4979.

  • Carrier Information

  • Authorized Company Officer

  • Dispatching

  • Billing

  • Incident / Accident Claims

  • Emergency Contacts

  • Broker - Carrier Agreement

  • Please review the full agreement before signing. You can view and download the Broker-Carrier Agreement here: https://drive.google.com/file/d/10ug-T3dW2jxd6T00lWT_zYR62-GDu89_/view?usp=drive_link 

  • This Transportation Agreement (the "Agreement"), is entered into this    *    day of   *, 20    by and between Coastline Connect Inc. (hereinafter referred to as "BROKER") and   * (hereinafter referred to as "CARRIER")   

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  • Motor Carrier Certification of Compliance

    CHP 809 (Rev. 4-16) OPI 062
  • I, the undersigned, certify that* holds a Motor Carrier of Property (MCP) Permit, Number *, which is valid through   Pick a Date*, and the above named carrier is knowledgeable of and in compliance with all applicable statutes and regulations including but not limited to (check al that apply):  

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  • Services Provided For (Contracting Carrier): Coastline Connect

    Contracting CA Number: 6132395

    One copy of this certificate shall be provided to the person for whom services are provided (the contracting motor carrier); one copy shall be retained by the motor carrier of property (the contracted motor carrier). Copies shall be retained by both parties for the duration of the contract or period of service plus two years, and shall be presented for inspection upon the request of an authorized employee of the California Highway Patrol or the Department of Motor Vehicles.

  • W-9

    Request for Taxpayer Identification Number and CertificationGo to www.irs.gov/FormW9 for instructions and the latest information.
  • Please fill out the W-9 form fields below. To view the federal W-9 form and its instructions, scroll to the bottom of the page or click here.

  • 4. Exemptions (codes apply only to certain entities, not individuals; see instructions on W-9 page 3):

    (Applies to accounts maintained outside the United States.)

  • 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 instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

    Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

  • Social security number (one digit per box)

  • or Employer identification number (one digit per box)

  • 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 for Part II, later.

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  • REQUIRED DOCUMENT UPLOADS

  • Insurance Certificates

    Certificates must show Coastline Connect as additional insured
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  • Equipment Details

  • Information needed - Unit, License Plate, State, and Vehicle Identification Number (VIN)

    Feel free to use our Equipment List Template

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  • Authorized Driver Details

  • Information needed - names and hire dates

    Feel free to use our Driver List Template

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