Vehicle Trailer Request Form

VEHICLE TRAILER REQUEST FORM

THIS VEHICLE TRAILER REQUEST FORM (the Agreement) is entered into by the parties identified below to govern the temporary assignment, use, and payment for a vehicle trailer owned or controlled by the Provider and requested by the Requester under the terms set forth herein.

WHEREAS

WHEREAS, Provider agrees to make available a vehicle trailer to Requester for business operations consistent with the scope and limitations set forth in this form; and

WHEREAS, Requester represents that the requested use is necessary for legitimate business purposes, that Requester meets insurance and operator qualifications, and that Requester will comply with Provider policies and applicable law while in possession of the trailer.

REQUESTER INFORMATION

TRAILER DETAILS

Flatbed    Enclosed    Utility    Gooseneck

TRIP DETAILS

Request Date:    Requested Pickup Date:    Expected Return Date:

INSURANCE AND AUTHORIZATION

Requester certifies that the necessary insurance coverage is in force for the proposed use and that proof of insurance is provided as required below.

Proof of required insurance attached    Driver/operator is authorized and licensed

SCOPE OF WORK

Describe the scope of activities for which the trailer will be used. Include loading/unloading plans, expected stops, and any special handling requirements. Provider approval is conditional on the Scope of Work and adherence to Provider safety rules.

PAYMENT TERMS

Requester agrees to pay Provider for the use of the trailer according to the following terms:

TERM AND TERMINATION

The assignment commences and terminates as follows. Provider may suspend or terminate the assignment for safety, breach, or unauthorized use.

Start Date:    End Date:    Required Notice to Terminate:

CONFIDENTIALITY

Each party shall maintain the confidentiality of non-public operational, technical, and business information disclosed in connection with this request. Confidential information excludes information that is or becomes publicly available through no breach by the receiving party, was lawfully received from a third party, or is required to be disclosed by law or valid legal process.

Requester acknowledges and agrees to the confidentiality obligations set forth above.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement is governed by the substantive laws of the state or jurisdiction in which Provider is principally located, without regard to conflict-of-law rules. The parties consent to the exclusive jurisdiction of the state and federal courts located in that jurisdiction for disputes arising under this Agreement.

This form, together with any approved attachments or schedules signed by Provider, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, understandings, and agreements, whether written or oral.

ADDITIONAL TERMS / SPECIAL INSTRUCTIONS

APPROVAL (FOR PROVIDER USE)

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