CARRIER INFORMATION SHEET COMPANY NAME: MAILING ADDRESS: CITY, STATE, ZIP: TELEPHONE: WATS: FAX: OPERATIONAL CONTACTS: MAILING ADDRESS:

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1 CARRIER INFORMATION SHEET COMPANY NAME: MAILING ADDRESS: CITY, STATE, ZIP: TELEPHONE: WATS: FAX: OPERATIONAL CONTACTS: REMITTANCE (If different from above): MAILING ADDRESS: CITY, STATE, ZIP: TELEPHONE: WATS: FAX: FINANCIAL CONTACTS: ICC# FEDERAL ID: NUMBER OF DRY VANS: REEFERS: FLATBEDS: MAY WE ADVANCE YOUR DRIVERS? YES NO INSURANCE COMPANY NAME: CONTACT: TELEPHONE: LIST THE STATES YOUR COMPANY FREQUENTLY DELIVERS TO: SPECIFY CARRIER TYPE: CONTRACT COMMON OR BOTH TWO TRADE REFERENCES: PHONE: PHONE: 855 Progress Industrial Blvd, Lawrenceville, GA (678) (800) Fax (678)

2 Thank you for choosing to do business with PERFORMANCE TRANSPORTATION, INC. We realize you had a choice and want to ensure you have a good experience that will lead to mutual success of our companies. In order to make the process flow smoothly, please complete & sign the enclosed forms and provide the pertinent information on your company: 1. Carrier Information Sheet 2. W-9 form 3. Carrier Contract/Broker Agreement 4. Up-to-date Cargo & Liability Insurance Certificate 5. Copy of ICC Authority. Our Operational and Administrative procedures are as follows: BILLING: All invoices will be paid 30 days from receipt, subject to no damages or shortages due to carrier negligence. The ORIGINAL bill of lading must be legibly signed by the consignee(s). All signed legible BOL pages, Load Confirmation Sheet, and Release number must be mailed with your invoice to the following address: PERFORMANCE TRANSPORTATION, INC. 855 PROGRESS INDUSTRIAL BLVD. LAWRENCEVILLE, GA DISPATCHING: Drivers must call PERFORMANCE TRANSPORTATION at for dispatch, directions, and specific procedures for loading and delivery. Any delays or circumstances involving the handling of a shipment should be reported immediately by the driver and/or dispatch. LOADING& UNLOADING: Any loading and/or unloading must be approved by PERFORMANCE prior to the service taking place. Drivers are required to call PERFORMANCE dispatch when loaded with billing information and upon delivery to the customer. 855 Progress Industrial Blvd, Lawrenceville, GA (678) (800) Fax (678)

3 BROKER/CARRIER AGREEMENT This Agreement shall govern the services provided by, a licensed motor carrier pursuant to Docket No. MC- (hereinafter referred to as CARRIER and PERFORMANCE TRANSPORTATION, INC. (hereinafter referred to as BROKER ), a licensed property broker pursuant to Docket No. MC BROKER is an agent authorized by its customers to negotiate and arrange for transportation of their shipments in interstate commerce. 2. CARRIER shall transport a series of interstate shipments arranged by BROKER or SHIPPER by use of motor vehicles for a continuing period of time for the exclusive use of a service designed to meet the distinct needs of all parties involved and pursuant to load confirmation sheet(s) provided by Broker. 3. CARRIER warrants to Broker (and its shipper s principals) that it meets the following criteria: (a) CARRIER shall maintain all risk cargo insurance in the amount of at least $100,000 per shipment; (b) CARRIER shall maintain public liability insurance in the amount of at least $1,000,000, as required by federal regulation (BMC-91 on file); (c) CARRIER shall maintain workers compensation insurance as required by state law; (d) CARRIER agrees to have their insurance company list BROKER as Certificate Holder on each of their policies for General Liability, Public Liability, and All Risk Cargo. The insurance company is required to fax a copy of the above mentioned coverages to Broker, as well as mail an original copy to Broker; (e) CARRIER shall maintain satisfactory U.S. DOT safety ratings and is otherwise authorized to provide the proposed services; and (f) Carrier shall be in compliance with all applicable laws. 3. BROKER shall pay CARRIER for services rendered in an amount equal to the rates and accessorial charges agreed to on BROKER s load confirmation sheet or other signed writing. CARRIER must submit ORIGINAL signed Bill of Lading and/or Proof of Delivery with invoices to BROKER as agent for the shipper. Payment terms shall be thirty (30) days from receipt of the original signed documents, excluding mail time (payment is on Fridays only). For further detail of our payment term, please contact our general manager, Jason Woods, at (678) Governing Rules. The following rules shall apply: (a) The terms of the uniform straight bill of lading; (b) Standard claims rules otherwise applicable to common carriers (49 C.F.R. '370 and carrier s rules tariffs); (c) Cargo claims liability as set forth in the Carmack Amendment (49 U.S.C. '14706); (d) Destination market value for lost or damaged cargo, no special or consequential damages unless by special agreement; (e) Claims will be filed with CARRIER by Shipper; and (f) BROKER s customer is third party beneficiary of this Agreement. 6. Released Rates. Rates governing movements will be established to comply with prior rate schedules verbally agreed upon between BROKER and CARRIER. The verbal contract will be reduced to writing by CARRIER submitting its invoice and said invoice being accepted by BROKER. 7. Shipping Document Execution. CARRIER is to be named on the bill of lading as the Carrier of record, and BROKER shall be shown as the third party payor of all freight charges. Page 1 of Progress Industrial Blvd, Lawrenceville, GA (678) (800) Fax (678)

4 8. Indemnification. CARRIER agrees to indemnify and hold BROKER and its customers harmless from any claims or loss caused solely by any act or omission of CARRIER, its employees or agents in the performance of this Agreement or the services provided hereunder. 9. RELATIONSHIP: The relationship between BROKER and CARRIER shall, at all times, be that of independent contractors. Carrier and any of its approved carriers or agents shall employ, pay, supervise, direct, discipline, discharge, and assume full responsibility for all persons required for the performance of CARRIER s duties under this Agreement. Under no circumstances shall CARRIER or any of its agents, or employees, deemed to be or hold themselves out as employees of BROKER or any SHIPPER. 10. NO DOUBLE-BROKERING: CARRIER agrees not to re-broker or co-broker, assign or interline the shipments hereunder tendered to CARRIER by BROKER without the advance written authorization of BROKER. Violation of this policy may be grounds for immediate termination of this Agreement. If BROKER becomes aware of such co-brokering activity by CARRIER prior to payment of any compensation otherwise due CARRIER, BROKER may withhold payment to CARRIER and may instead pay appropriate compensation to the carrier who actually transported the shipment. BROKER will deem any acceptance of a shipment by CARRIER as a common or contract carrier and subsequent subcontracting of this shipment to any third party as an assignment of the right to be compensated for that shipment to the third party. Upon Broker s payment to delivering carrier, CARRIER shall be released from any liability to BROKER under this agreement. CARRIER will be liable for consequential damages (including but not limited to reasonable attorney s fees) for violation of this Paragraph. 11. Law and Integration. This written Agreement, together with any load confirmation, contains the entire agreement between the parties and may only be modified by signed written agreement. Georgia law, venue and jurisdiction shall apply. 12. This Agreement shall be for the period of one (1) year from the date signed by both parties and shall be automatically renewed from year to year thereafter, subject to the right of either party to cancel or terminate upon written notice. 13. NO BACK SOLICITATION: CARRIER agrees to not back solicit any customer of BROKER, either directly or indirectly. As liquidated damages, CARRIER grees to pay back a ten percent (10%) commission on all traffic handled by customers first introduced to CARRIER by BROKER for a period of one (1) year following cancellation of this Agreement. Signed this day of, 20 CARRIER By: Print Name: Title: BROKER PERFORMANCE TRANSPORTATION, INC. By: Print Name: JASON WOODS Title: General Manager Page 2 of Progress Industrial Blvd, Lawrenceville, GA (678) (800) Fax (678)

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8 PERFORMANCE TRANSPORTATION, INC. CREDIT INFORMATION LOCATION: 855 Progress Industrial Blvd. Lawrenceville, GA PHONE: (678) , FAX: (678) MAILING ADDRESS: 855 Progress Industrial Blvd, Lawrenceville, GA TYPE OF BUSINESS: Transportation Broker CORPORATE OFFICERS: Kevin Stewart President Dan Strader Vice President COMMERCIAL BUSINESS REFERENCES: 1. 7 Hills Transport 2. Windy Hill Foliage Cartersville, GA Marshfield, WI Phone: (800) , Fax: (770) Phone: (715) , Fax: (715) Attn.: Linda Attn.: Lenise 3. Bulldog Freightway, Inc. 4. Mobley Transport Fresno, CA Locust Grove, GA Phone: (559) , Fax: (559) Phone: (404) , Fax: (770) Attn.: Steve Attn: Kay Mobley 5. Snico Cartage, Inc. 6. Patriot Carriers, Inc. Olive Branch, MS Berryville, VA Phone: (662) , Fax: (662) Phone: (540) , Fax: (866) Attn.: Tiffany Bell Attn.: Liz Parker Federal ID# ICC MC Broker Authority# Broker s Trust fund Agreement under 49 U.S.C Payment Term 30 Days from Receipt of Invoice excluding mail time (We pay only on Fridays). For further detail of our payment term, please contact our Operations Manager, Jason Woods, at (678) Updated March 11, 2016

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