Required Carrier Information and Documents

MC # 867453

Required Carrier Information and Documents

___ Signed Transportation Contract ___ Copy of Authority ___ W-9 ___Company Profile

___ Certificate of Insurance with Tortorigi Logistics, LLC listed as certificate holder:

Tortorigi Transport, LLC

PO Box 96

Trussville, AL 35173

Send Completed Packet back to:

Carrier Compliance

Fax: 800-305-0423

Email:

Office: (205) 438-7301

Carrier Information:

Carrier Name: ______

Carrier Mailing Address: ______

City: ______State: ______Zip: ______

Phone: ______Fax: ______Email: ______

MC #: ______DOT #: ______Fed ID# ______

Equipment: Vans _____ FWS _____ Step Decks _____ RGN _____ Other: ______

Do you use a factoring company ____No ____ Yes, If yes, please provide factoring company information below:

Factoring Company Name: ______

Address: ______City: ______State: ____ Zip: ______

Tortorigi Transport, LLC Billing Requirements:

(1) Signed Rate Confirmation

(2) Signed Clean Legible BOL

(3) Numbered Freight Invoice

Remit this information to Tortorigi Transport, LLC via Email or Fax to the contact listed above. If you have questions, please contact our office 205-438-7300.

Brokerand Contract CarrierAgreement

TheAgreementmadethis,,day of,20 _,byandbetweenMC # aContractMotor Carrier operating under authority of theFederal Motor Carrier SafetyAdministration (hereinafterreferredtoas“Carrier”)andTortorigi Transport, LLCa licensedpropertybroker,

(hereinafterreferredtoas“Broker”).

WITNESSETH

WHEREASBROKERis actively engagedinthebusiness of solicitinggoods andmerchandisefor transport onbehalf of contractmotorcarriers,pursuant toitsFederal MotorCarrier Safety Administration operatingauthorityMC # 867453

WHEREASCARRIERrepresents that it isa Contract Motor Carrier,having therequired operating authority,licenses andpermits fromany andallGovernment Agencies.

CARRIERrepresentsthat itis engagedinthebusinessof transportingmerchandiseandis desirousof transporting merchandiseofferedfor shipmentthroughtheservicesof BROKER.

NOWTHEREFORE,for andinconsideration of theaboveandforgoingandthemutual agreements and promises containedherein,andfor other goodand valuableconsideration.Thereceipt andsufficiency of whichare herebyacknowledged,theparties heretointending tobelegallybound,dohereby agree as follows.

1.BROKER agrees to offer atleast oneshipment toCarrier andCarrieragrees totransport said merchandiseusing its ownequipment, andsuchadditional quantities of merchandiseas Brokermaytender subjecttotheavailability offreight and of suitableequipment.

2.CARRIERagreestoprovideandmaintain,atits solecost andexpense,insuranceagainst liability forinjuriesto or death of persons anddamage toproperty,ina singlecombined limit of not lessthan$1,000,000 per occurrence,andfor loss or damagetofreightinanamount not lessthan$100,000,andany additionalinsurancerequiredbyapplicablelaws, rules and regulations without exclusions.CARRIER agreestoprovide writtenproof of suchcoverageand agrees tonameBROKER asa certificate holder andadditionalinsured onsaidpolicies. Additionally, CARRIER agrees tonotifyBROKERinwriting of any expiration or cancelation of theaforementionedinsurancecoverage30 days prior toexpiration orcancelationandshall providereplacementcertificatestoevidencerenewalor replacement of any effectedpolicies.

Initial:

3.CARRIER agreestoprovideBROKERwitha copyof itsoperating authority obtainedfrom the Federal Motor CarrierSafetyAdministration.

4.BROKERagrees topayCARRIER forthetransportation of freightmovedunderthis agreement

inaccordancewiththeagreeduponrates set forthinwriting. CARRIER agrees totransport freightforBROKER pursuant totheagreeduponrates andinaccordancetothetermsof this agreement andany additional agreedupontermsconfirmedin writing.

5.CARRIER authorizesBROKER toinvoicetheshipper for freightchargesonbehalf of CARRIER. CARRIER agreestoreleaseandwaiveanyclaimagainstconsignor and or consigneefor freight chargesandagreestoseekpayment of freight charges onlyfromBROKER.

CARRIER agreestobill all charges directly toBROKERfor thetransportationservicesprovided pursuant tothisagreement.CARRIER agreestoprovidewithits billedchargesa corresponding signedBillof Lading.BROKER agrees tomakepayment toCARRIERwithin28 days of receiptof CARRIERSinvoiceand original signed Bill of Lading.

Anymodificationtothefreightcharges as originallybilledby CARRIER must besubmittedto and receivedbyBROKER within30 days of presentation of freight bill andpriortoBROKER making payment toCARRIER,otherwiseCARRIERwaivesany rights tomodify thefreight charges.

BROKERSpayment of anyinvoicewill satisfyBROKERSobligationswithrespecttothe shipment.

6.CARRIERshallissueandsigna standard Bill of Lading orreceiptacceptabletoBROKER and shipper uponacceptanceof ashipment,andshallbe liableforloss,damage ordelay of any shipmentwhileinpossession or control ofCARRIER.Theterms,conditions or provisions ofthe Bill ofLading orany othershipping formshall besubordinate totheterms of this agreement andthis agreement shall governintheevent of any inconsistent terms orconditions.

CARRIERSliability shall beginatthetime cargoisloadeduponCARRIERSequipment, andshall continueuntilcargo is deliveredtodesignatedconsigneeat destination.

7.CARRIER atits solecost andexpenseshall furnishallequipment requiredforitsservices and shallmaintainall equipment ingoodrepair andcondition.CARRIERshall assumeall responsibility forcompliance withall State,LocalandFederal Regulations.

8.CARRIERshall not brokeranyloads tenderedpursuant tothisagreement without prior writtenconsent fromBROKER.CARRIERshallnot cause or permit any shipmenttendered pursuant tothisagreement tobetransportedby anyother motorcarrier orinsubstitute servicebyship,railroadorintermodal,or by any other modes of transportationwithout prior writtenconsent of BROKER.

Initial:

9.CARRIER agreestoindemnify andholdharmlessBROKER against any andallclaims of any naturewhatsoeverarisingout of CARRIERSoperationsandactivities hereunder,including withoutlimitation,claims,lossesorliability for personal injury,propertydamageclaimsmade by shipperor itscustomers relatedtoany delayed orlate delivery by CARRIER,cargolossor damage, or anycombinationthereof, resultingfrom any act,omission,negligence or legal liability ofCARRIER,its employees or agents,whichmay occurduringtheperformance of services under this agreement, includingcourtcosts andattorney’s feesincurredindefending claims.CARRIER agrees andconsents toawithholding and offset of anymoneyowedto CARRIER by BROKERtobeappliedtothesatisfactionof any of theaforementionedclaims.

10.CARRIER agreestoindemnifyBROKER foranycourt cost or attorney feesincurredas a result of thebreach of this agreement byCARRIER.

11.Itis agreedthat therelationship of CARRIER toBROKER is that of anindependent contractor except that BROKERshallbetheagent for CARRIER for thecollectionandpayment of freight chargestoCARRIER.

12.CARRIER accepts full responsibility ofcargo,includingwithout limitationany overage, shortageand/or damageresulting inloss.CARRIERagreestoreport toBROKERimmediately uponbecoming aware of any damage,shortageor overageresulting inloss.Intheevent of any claimresultingfrom shortage,overage or damagetocargo,CARRIERaccepts full responsibilityincluding any amountssubject toinsurancedeductiblesor notcoveredbyall insuranceforany reason.CARRIER agrees andconsents tothewithholding ofany deductible amounts or anylossnot coveredbyinsurancefrom CARRIERSfreight settlement.

13.This Agreementshallbecome effective onthedate of executionfor a period ofoneyear and shallcontinuethereafter from yeartoyear.This Agreement andtherights andresponsibilities of each of thepartieshereunder,may beterminatedas follows:

(i)Immediately,uponthemutual writtenconsent of bothparties;and

(ii)Uponthirtydayspriorwrittennoticetothe other party.

14.Because of theconfidential nature ofCARRIERSrelationshipwith BROKER.CARRIER agrees not tosolicit traffic fromany shipper, consignee,orcustomer of BROKERwhere(1)theavailability of suchtraffic firstbecameknowntoCARRIER as aresult ofBROKERSeffortsor(2)wherethe traffic of theshipper,consignor,consignee orcustomer of the BROKERwasfirsttenderedto theCARRIER by theBROKER.If CARRIER breaches this agreement and“back Solicits”the BROKERScustomersand obtains trafficafter theinvolvedtrafficfirstbegins tomove,the BROKER shall beentitledtoa commissionfromtheCARRIERof 15% of thegross revenue received onthemovement of thetrafficfor a periodof oneyear fromthedate of “back- Solicitation”.

INITIAL:

15.Theclauses andparagraphs containedinthis Agreement areintendedtobereadand construedindependentlyof each other.If anyterm,condition or provision of this Agreement is heldby acourtofcompetent jurisdictiontobeinvalid,void or unenforceable,itisthe partiesintent thatsuchprovisionbereducedinscopebythecourt only totheextent deemed necessary bythatcourt torender theprovisionreasonableandaffected,impaired or invalidas aresult.

16.Theterms andconditionsof thisAgreement may bewaived only bywritteninstrument bythe partyagainstwhom enforcement of suchwaiversissought.Nowaiver bya partyinany one or moreinstances of anyterm andconditioncontained inthisAgreement, orfor any breach orany agreement orcovenantcontainedinthis Agreementshall bedeemedorconstruedtobea waiver of any otherterm or conditioncontainedinthisAgreement.

17.This Agreementconstitutes theentireagreement betweentheparties andthereare no further items or provisions,eitheroral orotherwise.This Agreementmay onlybemodifiedby awritteninstrument executedbybothparties.

18.This Agreementshallbebinding upon,shallinsuretothebenefit of, thepartieshereto,and their successors andpermittedassigns.

19.Thisagreementshall beconstruedinaccordancewithandgovernedbylaws ofthe State of Alabama.All actionsrelatedtothisagreementshallbebrought inthe State of Alabama inthe court of properjurisdictionlocatedclosest tothecorporate office ofthe BROKER.

IN WITNESSWHEREOF,theparties haveexecutedthis agreement by dulyaffixing their signatures under handandseal onthedate hereinabovefirst written.

Carrier Representatives Signature: CarrierRepresentatives Name (Print): Carrier RepresentativesTitle:

BROKER TortorigiLogistics LLC

Representatives Signature: Representatives Name (Print) RepresentativesTitle

WORKERSCOMPENSATIONHOLDHARMLESSAGGREEMENT

This is tocertifythat we,theCARRIER,are incompliancewiththeWorker’sCompensationLaws of our state.Furthermore,wetheCARRIER,agreetorelease,indemnify andholdharmlessTortorigiLogistics, LLC fromallclaims,fines andactions,includingany awardbya WorkersCompensationCourt or similaradministrativebody orcourt oflaw,arising out of claimsbyanemployee or agent of the carrier forworkrelatedinjuries.

Carrier name:

Carrier MC#:

AuthorizedSignature:

PrintedName:

Title:

Date: