SERVICES AGREEMENT
PERSONAL INFORMATION
Your Name:
First Name
Last Name
Email:
example@example.com
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Today's Date:
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CARRIER INFORMATION
Company Name
Company MC Number
Company DOT Number
How long has your Authority been active for?
Truck Type / Model
Truck VIN Number
Trailer Type and Year
How much money are you looking to gross per week?
How often are you looking to be home?
How many trucks are you bringing on board with us?
What type of freight will you be hauling with us? (Dry Van, Flatbed, Reefer, Box Truck)
Name of Driver Referral
Phone Number of Driver Referral
Please enter a valid phone number.
Format: (000) 000-0000.
REQUIRED DOCUMENTS - Please Upload Clear Copies
W9 Upload
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CDL-A Driver's License Upload
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MC Authority Letter Upload
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Certificate of Insurance (COI) Upload
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Notice of Assignment (NOA) from Factoring Company
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Do you have a Factoring Company?
Yes
What is the name of your Factoring Company?
LIMITED POWER OF ATTORNEY
I authorize On Demand Trucking to act as my Dispatcher on my behalf. I authorize On Demand Trucker to communicate to brokers on my behalf, to sign rate confirmations on my behalf once I agree to the load, and to book loads on my behalf.
Yes
Signature
DISPATCH / CARRIER AGREEMENT
I agree to pay On Demand Trucking 10% of the total load amount that is written on the rate confirmation by the end of each week. If power only trailer is used and broker pays for trailer, I will pay On Demand Trucking 10% of the trailer rate con. On Demand Trucking will NOT take any percentage of any detention you are owed.
Yes
CARRIER is responsible for paying DISPATCH 10% of the total gross of loads that I fail to deliver or arrive late. CARRIER is 100% responsible for paying any and all late fees, and if late, CARRIER STILL owes On Demand Trucking what is written on the rate confirmation.
I understand
I understand that if revenue for a shipment or shipments is uncollectable, On Demand Trucking will be held harmless and no penalty or deduction of fees will be made.
Yes
I understand that while working with On Demand Trucking, I am solely to use On Demand Trucking for dispatch and I cannot work with any other company or book my own loads. On Demand Trucking requests a written two weeks notice. Failure to abide by both of these conditions will result in a $500 penalty. The first load must be accepted within 48 hours after this form is signed. If we do get you secured on a dedicated lane, you will be locked in for the duration of that dedicated lane.
Yes
These terms of service are governed by the laws of North Carolina. By using our terms of service, you consent to jurisdiction of the courts in North Carolina to settle any disputes. I understand that if I do have a dispute, I will first attempt to contact the owner to resolve the dispute. All legal action must be taken within 14 days after contract is terminated.
I understand
I agree to submit all BOL's via email to careers@on-demand-trucking.com after every load.
Yes
I agree to all terms and conditions set forth above in this agreement.
Yes
Signature
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