Dispatcher Agreement

Carrier or Trucking Company Name *

Enter the name or name of your Trucking Company

Trucking Information *

Please list your MC#, DOT#, Truck# and Trailer#

Your Address *

Where do you live?

Country

City

State

Zip code

Phone *

Email *

Terms and Conditions *

Carrier hereby grants authorization to Express Logistics Network to act as its agent for the sole purpose of searching for and booking loads, processing all brokerage paperwork and obtaining/submitting all necessary documents required in order to expedite loads and dispatch via telephone, fax or e-mail. All billing, invoicing and collections of revenue from customers, brokers, shippers, consignees, etc. - are the sole responsibility of the carrier. If revenue for a shipment or shipments is uncollectible, Express Logistics Network will be held harmless and no penalty or deduction of fees will be made. The carrier agrees to maintain all proper licenses and permits to conduct business as a motor carrier in the area of intended operation. Additionally, carrier agrees to maintain general liability and cargo insurance at the amounts set forth by the home state of the carrier. Express Logistics Network will be held harmless in the event of any and all claims. As loads are picked up, delivered, and carrier is paid FIRST, an amount equal to the above stated percentage will be payable to: Express Logistics Network. Payments to the dispatcher, once carrier is paid, are to be conveniently paid with any Debit or Credit Card. Carrier will be invoiced once they are paid from Broker or factoring company. Either party has the right to end this agreement without cause at any time with seven (7) days’ notice by written request.

I have reviewed and agree to Terms & Conditions

Consent *

I authorize Express Logistics Network to complete all broker Carrier Packets and Rate Confirmations on my behalf.

I consent to having the Carrier Packets and Rate Confirmations completed by Express Logistics Network on my behalf.

Please upload a copies of your W9. *

Hold down Control Button during selection to select multiple W9 forms.

Please upload MC Authority letter *

Allowed file types: Image, PDF, Microsoft Word

Please upload your Certificate of Insurance *

Allowed file types: Image, PDF, Microsoft Word

Signature Date

Please Sign Above the Line (REQUIRED)

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