Vehicle Truck Application

VEHICLE TRUCK APPLICATION

Whereas

WHEREAS, Applicant Name: (the "Applicant") seeks to register and apply for approval to provide trucking services to Company Name: (the "Company"); and

WHEREAS, the Company requires certain information, representations and agreements from the Applicant concerning the vehicle(s), insurance, operating authority and performance obligations prior to permitting the Applicant to operate on the Company's behalf; and

WHEREAS, the parties desire to record the Applicant's qualifications and the basic terms under which the Applicant may be accepted to provide transportation services to the Company.

Applicant Information

Vehicle Details

Insurance & Operating Authority

Insurance Carrier:   Policy Number:   Policy Limits:

Policy Expiration Date:   Cargo Insurance Limits:

Operating Authority Details / Permit Numbers:

Scope of Work

Describe the primary services to be provided, typical routes, cargo types, and any special operational limitations or requirements:

Payment Terms

Compensation Amount or Rate:

Payment Schedule and Method:

Late Payment Fee and Collection: If payment is not received within days, a late fee of will apply and the Company may withhold further dispatches until cured.

Term and Termination

Term Start Date:   Term End Date (if applicable):

Either party may terminate this Agreement for convenience upon days' prior written notice. Material breach that remains uncured for days following written notice may result in immediate termination.

Confidentiality

The Applicant shall treat as confidential all non-public business information received from the Company, including but not limited to rates, customer lists, routes and contract terms. The Applicant will not disclose Confidential Information except to its employees, agents or insurers on a need-to-know basis and shall use at least the same degree of care to protect such information as it uses to protect its own confidential information, but in no event less than reasonable care. Confidentiality obligations survive termination for a period of two (2) years.

Representations, Warranties & Certifications

The Applicant certifies that all information provided in this Application is true and complete. Applicant represents that it holds in good standing all necessary licenses, operating authorities and insurance required to perform the services described. Applicant agrees to notify the Company promptly of any material change in insurance, authority, or the condition of the vehicle(s).

Governing Law

This Application and any resulting agreement between the parties shall be governed by and construed in accordance with the laws of the State of without regard to its conflicts of law principles.

Entire Agreement

This Application, together with any attachments, certificates of insurance, permits and any agreements executed by the parties that reference this Application, constitute the entire agreement between the parties with respect to the subject matter hereof and supersede all prior or contemporaneous understandings, representations or agreements, written or oral.

Attachments and Required Documents

Applicant shall provide current certificates of insurance evidencing required coverage, a copy of operating authority, vehicle registration, and any driver qualification files upon request. Applicant acknowledges that acceptance is conditioned upon satisfactory review of all required documents and references.

Acknowledgement & Consent

Applicant authorizes the Company to verify any information provided and to obtain motor carrier safety, accident, and insurance history. Applicant agrees to comply with applicable federal, state and local regulations in performing services.

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