Falcon Logistics LLC

This agreement is made this ________ day of ________________, 20____, by and between
Falcon Logistics LLC, hereinafter referred to as the "Dispatcher" and
________________________________________________________________,
hereinafter referred to as the "Carrier."

TERMS OF SERVICE FOR BOTH PARTIES:

For Dispatcher:

1. Dispatcher will find and book loads for the Carrier as per their preferences.
2. They will do all the paperwork (By the broker) on behalf of the Carrier and send a signed copy of
the rate confirmation to the Carrier on the given email address.
3. Dispatcher will share all the information with the Carrier regarding the load they are under.
4. Dispatcher will be honest in all they do as they represent the Carrier, they will treat the Carrier's
business as their own and do everything they can to ensure the Carrier is able to meet their
financial goals.

The Carrier:

1. The Carrier agrees to pay $50.00 to the Dispatcher as their service charge. Invoices will be sent
out to the Carrier weekly every Tuesday on their given email address.
2. Once a load is booked, it will be the responsibility of the Carrier to communicate promptly
regarding any problems, issues, delays, shortages, damages or lateness with the Dispatcher,
Broker, Shipper or the Receiver accordingly.
3. The Carrier and its representatives are expected to be honest when it comes to regular check
calls, current locations, ETAs and ability to pick up or deliver a load on time.
4. The Carrier will notify the Dispatcher if there is any change in their authority, insurance or
ownership.
 REQUIRED DOCUMENTATION:

Copies of:

• Filled and signed Dispatch Agreement.

• Motor Carrier Certificate (MC Certificate.)
• Certificate of Insurance.
• W-9 Form (Tax Payer Form.) Even if you do not have one, we will send you a blank copy, you
can fill and sign it and send it to us.

CARRIER PROFILE FORM

Business Name: __________________________________________________________________

DBA (If Any): _____________________________________________________________________

Mailing Address: __________________________________________________________________

___________________________________________________________________

Billing Address (If Different): ________________________________________________________

__________________________________________________________________

Email Address: ___________________________________________________________________

Office Number: __________________________ Cell Number: ____________________________

Contact Person: ___________________________________________________________________

MC#: _______________ DOT#: _________________ FEIN (TAX ID): _________________________

AREAS OF OPERATION
Check all that apply

United States: ______ (If all 48 states) Restricted States: _______________________________

If Specific States:
AL _____ AR _____ AZ _____ CA _____ CO _____ CT _____ DE _____ FL _____ GA _____ IA _____ ID _____

IL _____ IN _____ KS _____ KY _____ LA _____ MA _____ MD _____ ME _____ MI _____ MN _____ MO _____

MS _____ MT _____ NC _____ ND _____ NE _____ NH _____ NJ _____ NM _____ NV _____ NY _____ OH _____
 OK _____ OR _____ PA _____ RI _____ SC _____ SD _____ TN _____ TX _____ UT _____ VA _____ VT ___
WA _____ WI _____ WV _____ WY _____.

EQUIPMENT INFORMATION

Number of Trucks: _____________

Number of Trailers: ________________
Power Only: ________________

Number of Vans: 48ft: ________ 53ft: ________ Air-ride: ____________ Vented: ___________

Number of Reefers: 48ft: ________ 53ft: ________ Air-ride: ___________ Vented: ___________

Number of Flatbeds: 48ft: ________ 53ft: _________ Straps: _________ Tarps: __________

Number of Step decks: 48ft: ________ 53ft: ________ Straps: __________ Tarps: ____________

Number of Drivers: _______________ Solos: __________________ Teams: ___________________

Driver Touch (Y/N): __________________ Multiple Picks/Stops (Y/N): _______________

SIGNATURE

Name: _________________________________________________ Position: __________________________________________

Signature: ____________________________________________ Date: ______________________________________________

FACTORING COMPANY INFORMATION

(Only if applicable)

Factoring Company Name: _______________________________________________________________________

Company Address: _____________________________________________________________________________
_______________________________________________________________________________
Contact Person: ____________________________________ Phone Number: _____________________________
Email Address: _________________________________________________________________________________
 INSURANCE COMPANY INFORMATION

Company Name: _______________________________________________________________________________

Address: _____________________________________________________________________________________
_____________________________________________________________________________________
Agent Name: _________________________________________________________________________________
Phone Number: _________________________________ Fax Number: __________________________________
Email Address: ________________________________________________________________________________
Policy Number: _________________________________

MULTIPLE TRUCKS FORM

(Only for Carriers with multiple trucks)

Driver Name Phone Number Truck# Trailer#

______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
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