Shipping Request Form

SHIPPING REQUEST FORM & SERVICE AGREEMENT

Request Details

Request ID:     Request Date:

Parties

Addresses

WHEREAS (Recitals)

WHEREAS, Client requires transportation, handling and delivery services for goods described herein and has requested that Carrier perform such services under the terms and conditions of this Shipping Request Form & Service Agreement; and

WHEREAS, Carrier represents that it is duly licensed, insured and qualified to provide the requested shipping services and agrees to carry out such services consistent with the scope described below and applicable law; and

NOW, THEREFORE, Client requests and Carrier agrees to provide the shipping services on the terms set forth in this form, effective as of Effective Date: .

Shipment Details

Scope of Work

Carrier will provide pickup, transportation, delivery, and any agreed ancillary services for the shipment described above in accordance with the instructions provided by Client and consistent with Carrier's normal operating procedures. Specific tasks to be performed are set forth below; deviations require prior written acceptance by both parties.

Payment Terms

Client agrees to pay Carrier the charges set forth below. Charges are payable in U.S. dollars unless otherwise agreed in writing. Carrier's liability for loss or damage is governed by the limits stated in this Agreement and by any applicable statute.

Late Payment: Any amounts not paid when due shall accrue late charges at the lesser of 1.5% per month or the maximum rate permitted by law, plus recovery costs including collection costs and reasonable attorneys' fees.

Term and Termination

This Agreement commences on the Start Date below and continues until the End Date or until the services described herein are completed, unless earlier terminated in accordance with this section.

Termination for Cause: Either party may terminate this Agreement for material breach by the other party if the breach remains uncured for the notice period specified above. Termination will not relieve either party of obligations accrued prior to termination.

Confidentiality

Each party shall treat as confidential all non-public business information disclosed by the other party in connection with this Agreement (excluding information that is or becomes publicly known other than by breach). Confidential information shall be used solely for performance of obligations under this Agreement and may not be disclosed except to employees, contractors or insurers who need to know and who are bound by confidentiality obligations at least as protective as those herein. This obligation survives termination of this Agreement for a period of two years.

Liability and Limitation

Carrier's liability for loss, damage or delay shall be limited to the lesser of the declared value stated above or the limits set forth by governing statute. Carrier disclaims liability for loss or damage resulting from improper packing, inherent vice of the goods, acts of God, public authority, or other causes beyond Carrier's reasonable control. Any higher limits of liability or additional coverage must be agreed in writing and may be subject to additional charges.

Governing Law

This Agreement shall be governed by and construed in accordance with the substantive laws of the state specified below, without regard to conflict of law rules.

Entire Agreement

This document, together with any attachments and accepted written schedules or rate confirmations, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior or contemporaneous agreements, proposals or representations, whether written or oral. No modification is effective unless executed in writing by both parties.

Acknowledgement and Certifications

Client certifies that it is authorized to ship the described goods and that the information provided on this form is complete and accurate. Carrier certifies that it holds such licenses, permits and insurance required by applicable law to perform the services described herein.

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