Broker Application - Vehicle Management Solutions

Broker Agreement, Required Documentation

Vendor Profile, Signed Policies and Procedures Document – The policies and procedures document and Affidavit must be signed.

Insurance Certificate -Please request your insurance company to add Vehicle Management Solutions as a certificate holder. Minimum required $500,000 general liability, $50,000 On-hook.

Signed Copy of Affidavit of Acknowledgement of Responsibility – Company officials must acknowledge that they will be responsible for damage and that all of their drivers are familiar and intend to comply with DOT regulations, including the requirement for random drug and alcohol testing.

Completed and signed W-9 – IRS regulations require backup withholdings of any payment to a subcontractor of 30% if no W-9 is on file.

Written Substance Abuse Policy – A statement from your employee handbook or similar document is sufficient.

DOT or MC# – DOT or Motor Carrier # or State issued permit #

CONTACT NAME(Required)

First Name Last Name

COMPANY NAME(Required)

TYPE OF COMPANY(Required)

IF CORPORATION

ADDRESS(Required)

Street Address Address Line 2 City State ZIP Code

REMIT TO ADDRESS(Required)

OFFICE PHONE

CELL PHONE

FAX NUMBER

EMAIL(Required)

DOT NUMBER/MC NUMBER(Required)

YEARS IN BUSINESS UNDER CURRENT NAME:(Required)

FLEET SIZE (# OF UNITS)

FLEET CAPABILITIES(Required)

Light

Medium

Heavy Duty

Rotator

Landoll

Other

LIST PRINCIPAL(S)/OWNER(S)(Required)

PLEASE PROVIDE CONTACT INFO BELOW, IF DIFFERENT THAN PRINCIPAL(S)/OWNER(S)(Required)

Broker Agreement, Policies and Procedures

Drivers must report to dispatch daily on time and follow the guidelines of the incident that may be in place. Failure to report on time daily will result in non-payment for that day and potential termination from the program. Paperwork, including receipts for payouts, MUST be complete and turned in immediately when vehicle is delivered at the yard in order to be paid. All brokers must present themselves in the utmost professional manner when representing us on consignments. Uniformed Drivers – drivers must be clean, uniformed and wearing proper protective gear and ANSI 3 safety vests. Well Maintained Equipment – equipment must be legal and presentable. When starting a job for VMS, brokers will be provided with the location where drivers are to report along with the date, time and contact name(s) and phone number(s). Drivers must fill out Daily Log Sheet Broker invoices must be sent to VMS each Monday, along with the Daily Log Sheets. Payments are sent to brokers every Friday. Brokers must notify VMS immediately: if a driver is going to be absent, late or for any reason cannot complete a shift; if a truck breaks down; if a driver damages a vehicle; if a driver or a broker is asked to make a payout; if the driver is asked to make a recovery ( driver should take pictures of the scene and request instructions from the dispatch supervisor or branch manager – pre approval for additional compensation is require) 2 car carriers should pick up 6 or more vehicles per day unless CAT conditions of long-distance tows prevent it: Vehicle has already been picked up Vehicle not at the location given Authorities will not grant access to the vehicles location Authorities requesting paperwork not consistent with procedures Vehicles requires recovery or extrication Vehicle can not be towed without causing additional damage Upon reporting these conditions, the on-site coordinator may give the driver alternate assignments. A day is considered as 10-11 hours logged by each driver depending on conditions or traffic patterns.
CONFIDENTIALITY
The daily rate of compensation, including amounts paid for travel is considered confidential information. It will be considered a violation of this agreement for a company or its representatives, including drivers to discuss the rates or any other form of compensation with other companies or representatives of other companies including dispatchers, drivers or any other personnel from another company.

I understand that by accepting, I warrant the truthfulness of the information provided in the application and I have all the requisite to complete the application and execute all documents on behalf of the applicant, I consent for the application to be legally bound.

Phone

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Disaster Response Team Broker Application

Broker Agreement, Required Documentation

Disaster
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Application