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Home
Courier
Trucking
Warehouse
Moving
About
Contact
Proposal to Provide Courier Services
Proposal to Provide Courier Services
Name of Proposed Contractor
*
*If contractor is self-employed or a sole proprietor, the individual owner may sign. If contractor is a corporation, a corporate officer must sign this proposal. If contractor is an LLC, a managing member must sign this proposal. If contractor is another entity, specify the title of the person who signs this proposal.
Business Structure
*
Self Employed (Sole-Proprietor)
Corporation
LLC
Other
Street Address
*
City
*
State
*
Zip Code
*
Email
*
Office Phone
*
Mobile Phone
Other Phone
Schedule of service
When can contractor begin to provide courier service?
*
What days and hours of the day/night is the contractor able to provide courier services?
Sunday Hours
Monday Hours
Tuesday Hours
Wednesday Hours
Thursday Hours
Friday Hours
Saturday Hours
Insurance
Insurance Company
*
Policy Number
*
Expiration Date
*
Vehicle(s) to be used by contractor in providing services
For additional vehicles, use "Comments" field below
Vehicle #1
*
Year and Make
*
Covered by above insurance policy?
*
Yes
No
Vehicle #2
Year and Make
Covered by above insurance policy?
Yes
No
Vehicle #3
Year and Make
Covered by above insurance policy?
Yes
No
Names of each driver that contractor plans to use in providing services
In addition to completing this section, you will have to complete and submit a separate online form for each named driver. If the person filling out this proposal will also be a driver who performs the contracted services, then put the name of this person as Driver below.
Driver Name
*
Relationship of Driver to Business
*
-- Please Select --
Self-employed owner/sole proprietor
Employee/non-owner of LLC
Employee/owner of LLC
Other
Social Security Number
Driver License Number
*
State of Issuance
*
Expiration Date
*
Date of Birth
*
Street Address
*
City
*
State
*
Zip Code
*
Emergency Contact
*
Telephone Number
*
Relationship to Driver
*
Professional references for contractor (other service recipients, employers, etc)
Professional Reference #1
Telephone Number
Period Contractor Provided Services
Contractor's Role/Position/etc
Professional Reference #2
Telephone Number
Period Contractor Provided Services
Contractor's Role/Position/etc
Professional Reference #3
Telephone Number
Period Contractor Provided Services
Contractor's Role/Position/etc
Personal references for contractor
Personal Reference #1
Telephone
Relationship to Contractor
Personal Reference #2
Telephone
Relationship to Contractor
Additional comments
Comments
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