How to Save a Life Transportation Application

How to Save a Life Transportation Application

We utilize 256-bit encryption to protect your sensitive documents from the moment you hit "upload." Your information is stored on secure, private servers.
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Driver's License Number*
TLC License Number*
Vehicle Make and Model
Vehicle Year
Upload Driver's License (Image or PDF)*

Cancelof
Tax ID or Social Security Number*
Upload TLC License (Image or PDF)*

Cancelof
Upload Vehicle Registration (Image or PDF)

Cancelof
Upload Vehicle Insurance (Image or PDF)

Cancelof
Upload Vehicle TLC Diamond (Image or PDF)

Cancelof
Upload Vehicle inspection and registration, taken together in one image

Cancelof
Do you have any prior ride-sharing experience?

YesNo
How to Save a Life LLC (“the Company”) and the Contractor agree to the following terms and conditions:

1. Contractor will act as an independent contractor and not be considered an employee or agent of the Company during the performance of its duties under this Agreement.
2. Contractor agrees to provide transportation services for the Company, transporting passengers from one location to another.
3. Contractor has the freedom to work its own schedule and is not required to work any specific day, time, or shift.
4. Contractor will notify the Company that it is ready to complete trips for the Company by logging into the mobile application known as Trip Viewer.
5. Contractor will schedule pickups at the designated locations and will be compensated based on the following formula: Compensation = (Number of Trips)

6. The Company reserves the right to change the compensation formula at its sole discretion. The Company will notify Contractor of any proposed changes, and Contractor will have the opportunity to accept or reject the adjustments.
7. In the event of a change in the compensation formula, the parties will enter a separate Independent Contractor Agreement reflecting the revised terms. Upon execution of that Agreement, it will supersede this Agreement.
8. The Company reserves the right to deduct any amounts owed to the Company from Contractor’s compensation.
The Company agrees to remit payment to the Contractor within fourteen (14) days of the completion of each trip. Payment timelines may be affected by weekends or holidays; however, the Company will make reasonable efforts to issue payment as promptly as possible.
The contractor will receive an IRS Form 1099-MISC from the company.
The contractor will indemnify the company for any and all liability that the company may incur regarding the compensation provided to the contractor by the company, including any and all liability that may arise as a result of the contractor’s failure to pay the appropriate federal, state, or local taxes owed.

The contractor shall furnish the company with the necessary documents at the contractor’s own expense.
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Should be Empty: