Transportation Permission Form

TRANSPORTATION PERMISSION FORM

Client Name:

WHEREAS

WHEREAS, Client Name entered above desires transportation services for the persons or property described in this form and seeks permission for Provider to transport such persons or property under the terms set forth herein; and

WHEREAS, Provider is duly qualified and represents that it is licensed, if required, and maintains applicable insurance and safety procedures to provide transportation services requested by Client; and

WHEREAS, the parties desire to set forth the scope, payment, term, and legal conditions under which Provider will perform transportation services for Client.

SCOPE OF SERVICES

PAYMENT TERMS

Amount Payable: $   Payment Schedule:

Late Payment Fee:   Payments not received within the payment terms will incur the stated late fee, and Client will be responsible for collection costs and reasonable legal fees.

TERM AND TERMINATION

Commencement Date:   Termination Date:

Either party may terminate this Agreement for convenience upon days' prior written notice to the other party. Termination for cause may be effected immediately for material breach that is not cured within a reasonable period following written notice.

CONFIDENTIALITY

Each party shall maintain in confidence any nonpublic information obtained from the other party in connection with this Agreement and shall not disclose such information except to employees, agents, or contractors with a need to know or as required by law. Confidential information does not include information that is or becomes publicly available through no breach of this Agreement.

LIABILITY, INSURANCE, AND INDEMNIFICATION

Provider represents that it maintains commercially reasonable automobile liability insurance and workers' compensation insurance where applicable. Client acknowledges that transportation involves inherent risks.

Provider Insured:   Policy Number:   Coverage Amount: $

To the fullest extent permitted by law, Client agrees to indemnify and hold Provider harmless from claims arising from Client's negligent acts or willful misconduct and to the extent Provider's liability is determined by final judgment to arise from Provider's negligence, recovery shall be limited to available insurance proceeds.

MINOR PASSENGER CONSENT (IF APPLICABLE)

Is any passenger a minor (under 18)? Yes:   If yes, list minor's name:

Minor Date of Birth:   Relationship to Client:

PICKUP / DROPOFF DETAILS

EMERGENCY CONTACT

AUTHORIZATION AND RELEASE

By signing below, Client authorizes Provider to transport the named passenger(s) and to take any emergency action reasonably necessary for the safety and health of passenger(s). Client affirms that all information provided in this form is true and complete. Client understands and accepts that Provider will exercise reasonable care but is not responsible for delays, interruptions, or acts beyond Provider's control. Client releases and indemnifies Provider from claims arising from Client's negligence or failure to disclose relevant information.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement shall be governed by the laws of the state indicated by the parties' principal addresses without regard to conflict-of-law rules. This Agreement constitutes the entire understanding between the parties concerning the subject matter and supersedes all prior agreements and representations, whether written or oral. Any amendment must be in writing and signed by both parties.

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