Broker Contract Agreement

Thank you for selecting SJ FREIGHT SERVICES, LLC. Please verify the following items are completed, signed where required and returned to ensure the qualification process proceeds as timely as possible.

1 Certificate of Insurance for the following:

a. ) Auto Liability
b. ) Cargo Liability
c. ) Workers' Compensation

If you DO NOT carry Workers 'Compensation, you will need to complete the attached INDEMNIFICATION, DEFENSE AND HOLD HARMLESS AGREEMENT FOR WORKERS' COMPENSATION

2.) ICC Operating Authority
3. ) Carrier Profile
4. ) Carrier Contract Agreement
5. ) W-9 Tax Form

Please send the above via email or fax to
Email: DISPATCH@SJFREIGHTSERVICES.COM
Subject: Carrier Packet Fax: 888-660-7582

INDEMNIFICATION, DEFENSE AND HOLD HARMLESS AGREEMENT FOR WORKERS' COMPENSATION

This Indemnification, Defense and Hold Harmless Agreement for Workers' Compensation ("Indemnification Agreement") is made between (Carrier' S Name) whose principal office

is located at (Carrier's Address)

(Hereinafter known as "Carrier") and SJ FREIGHT SERVICES LLC, whose principal office

is located at 8026 WILLANCY LANE HOUSTON TX 77095

Carrier hereby represents and warrants that under state or federal law applicable to Carrier, it is exempt from providing workers' compensation coverage to drivers, owner/operators or other independent contractors working for Carrier. Carrier acknowledges and agrees that it will assume full and complete responsibility for compensation of any and all work-related injury occurring to any of its personnel and that Carrier shall fully indemnify, defend and hold SJ and its customers harmless for any claims, demands, lawsuits or administrative proceeding brought against SJ or its customer for any such work-related injury or employment obligations.

Further, Carrier shall indemnify, defend and hold SJ harmless for all damages of any kind whatsoever that arise from any misrepresentation, change in status or revocation of Carrier's warranty regarding exemption, coverage. All other obligations surrounding indemnification shall continue to be governed by the terms of the Broker/Carrier Agreement. This Indemnification, Defense and Hold Harmless Agreement for Workers' Compensation is executed , and the person signing represents that he/she has been or is specifically authorized to execute this document on behalf of Carrier.

   

 

U.S. Department of Transportation 1200 New Jersey Ave., S.E. Federal Motor Carrier Safety Administration Washington, DC

This License is evidence of the applicant's authority to engage in operations, in interstate or foreign commerce, as a broker, arranging for transportation of freight (except household goods) by motor vehicle. This authority will be effective as long as the broker maintains insurance coverage for the protection of the public (49 CFR 387) and the designation of agents upon whom process may be served (49 CFR 366 The applicant shall also render reasonably continuous and adequate service to the public. Failure to maintain compliance will constitute sufficient grounds for revocation of this authority.

Jeffrey L. Secrist, Chief Information Technology Operations Division

Quick Pay Program SJ FREIGHT SERVICES, LLC standard pay terms are thirty (30) days from receipt of carrier invoices and all proper documentation. If your organization is satisfied with these terms, no action is required. If your company is interested in our quick pay program, please complete this document and return to: Please return to: FAX: 888-660-7582 or billing@sjfreightservices.com

Standard terms: Payment is issued in 30 days from receipt of Invoice and proper documentation at no fee deducted from settlement.

Quick pay terms: Payment is issued in 1 business day from receipt of invoice and proper documentation at a 5% fee per invoice deducted from settlement.

PAYMENT POLICY: Every effort will be made to pay carrier invoices within 30 days of invoice receipt, provided the BILL OF LADING include the following:

They are Clearly Signed All copies are Legible No notice of claim has been given - BOL's "Free Of Discrepancies" A Signed Rate Confirmation has been returned Invoice is mailed or faxed to the SJ FREIGHT SERVICES offices. Occasionally original bills must be provided instead of copies and carrier will be notified of this in the load confirmation

By signing this form you accept these terms, fees and that you are an authorized representative of