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| Email: |
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| Detention Time |
$50 per hour after 2
hours from scheduled appointments. If driver is late or does not check
in, fee does not apply. Shipments that are first come-first serve,
detention does not apply.
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| MC #: |
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| Federal ID #: |
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| Driver's Name: |
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| Driver Contact #: |
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| Truck #: |
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| Trailer #: |
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| Alternate contact method: |
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| Load #: |
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| Miles: |
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| Flat Rate $: |
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| Lumber Fee: |
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| Product: |
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| Equipment Type: |
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| Trailer Length: |
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| Weight of Load: |
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| Agree Inclusive Rate $: |
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| Check In: |
Driver must check in daily 866-981-7447! Driver must call when arrive at origin and destination. Driver must fax BOL when load is delivered to 518-688-1112. Original BOL must be mailed with invoice. If any of these requirements are not met, a $25 dollar deduction will be made and or void of this contract!
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ORIGIN:
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| Address #1: |
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| Address #2:: |
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| Date of Pick Up: |
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| Time of Pick Up: |
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| Reference #: |
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| Phone number for directions only: |
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| Additional Stops: |
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| DESTINATION: |
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| Address #1: |
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| Address #2: |
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| Date of Drop Off: |
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| Time of Drop Off: |
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| Reference #: |
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| Phone number for directions only: |
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| Broker's E-Signature: |
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| Carrier's E-Signature: |
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E-Signature I understand that by entering these names and clicking the Submit button below, I have read, agreed and signed this contract. |
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