Credit Application - DGD Transport

Required Info

Company Name*

Physical Address*

Street Address Address Line 2 City State ZIP Code

Billing Address*

Street Address Address Line 2 City State ZIP Code

Maximum Load Value*

Do you accept Invoices Via Email? (copies of bills of lading can be attached)*

yes
no

Email for invoices

Do You Have LTL Freight*

yes
no

Company Classification

Year Business Started*

D & B Number

company type*

Owner name*

other type*

stock symbol

estimated full truckloads per week

Accounts Payable

Accounts Payable Contact*

First Last

accounts payable phone*

Accounts Payable Email*

will we invoice a third party payment processor*

yes
no

will we invoice other locations?*

yes
no

What additional locations*

Billing Information

Third Party Invoicing Company*

Third Party Payment Contact*

First Last

Third Party Payment Phone*

To process payment, may we exclude bills of lading from your invoice?*

Can we contact you to discuss Electronic Data Interchange (EDI) transactions?*

Do you require pallet exchange?*

Do you reimburse for unloading charges?*

Do you have the ability to pay via ACH?*

To process payment, do you require load tenders?*

Do you have any additional Billing requirements (We will reach out to your billing contact)?*

Bank Reference (Required For Maximum Credit)

Bank Name*

Bank Representative*

First Last

Bank Phone*

Checking Account Number*

Email Connected to Account*

Bank Fax Number*

Credit References (Required for Maximum Credit)

Company Name*

Contact Name*

First Last

Phone*

Company Name*

Contact Name*

First Last

Phone*

Company Name*

Contact Name*

First Last

Phone*

General Terms And Conditions

1. Customer hereby certifies that information furnished in this application is current and accurate. The term of this agreement shall be for one (1) year and shall automatically renew for successive one (1) year periods; provided, however, that either party may terminate this agreement on 30 days written notice to the other party. If the parties continue to conduct business after termination, the provisions of this agreement will continue to apply.

2. Our payment receiving terms are NET 30 days from invoice date.

3. Customer affirms that it is solvent, is not currently a party to any bankruptcy proceeding, is not being dissolved or otherwise liquidating its assets and can satisfy all financial obligations to Team DGD. Customer affirms that there are no open judgments, suits, or liens against Customer.

4. Finance charge of 1.5% per month (18% annum) added to accounts 30 days or more past due.

5. If Team DGD utilizes the services of a collection agency or attorney to collect any amounts due, Customer agrees to pay all associated collection costs, attorney fees, and court costs.

6. Customer will promptly notify Team DGD of any change in ownership.

7. Customer understands that Team DGD is a transportation broker only who arranges the transportation of freight by an independent third party motor carrier. Customer agrees that Team DGD will not fill out Bills of Lading and cannot be listed on Bills of Lading as the delivering carrier.

8. Team DGD records phone calls for quality assurance and training purposes.

9. In the event of cargo loss or damage, Customer must file a claim for the loss with Team DGD within nine (9) months from the date of such loss, shortage or damage, which for purposes of this agreement shall be the delivery date or, in the event of non-delivery, the scheduled delivery date. Customer agrees to assist Team DGD in the pursuit of a claim, including confirming the validity of the claim and claim amount with determination. If Team DGD pays a claim, Customer automatically assigns any and all of its rights and interest in the claim to Team DGD.

10. Customer understands motor carriers under contract with Team DGD are required to maintain cargo loss and damage liability insurance in the amount of $100,000.00 per shipment. By signing below, Customer acknowledges that loads valued in excess of $100,000.00 will not be tendered without first giving written notice to allow Team DGD and/or the contracted motor carrier the opportunity to arrange for increased insurance limits. Failure to provide written notice will result in your loads being insured with a maximum liability of $100,000.00.

11. The state courts located in Miami-Dade County, FL shall have exclusive and irrevocable jurisdiction and shall be the exclusive venue with respect to any claim, counterclaim, dispute or lawsuit arising in connection with any transactions, loads, or other business between Team DGD and Customer.

12. In the event Customer is negligent or breaches the terms of this Agreement and there is a resulting claim, lawsuit or damages asserted against Team DGD, it agrees to indemnify, defend and hold Team DGD harmless to the fullest extent of the law.

13. By signing below, Customer acknowledges that the individual executing this agreement has authority to do so and further authorizes Team DGD to contact each and every credit/bank reference provided.

I Accept The Terms And Conditions Contained In this Agreement*

ACCEPT

By selecting "Accept" above and submit below, I am signing this Agreement electronically. I agree my electronic signature is the legal equivalent of my manual signature on this Agreement. By selecting "I Accept" I, and the company/entity I have authority to bind, consent to be legally bound by this Agreement's terms and conditions.

Name*

First Last

Position*

Date*

Email*

Credit Customer Application

Credit App

Required Info

Company Classification

Accounts Payable

Billing Information

Bank Reference (Required For Maximum Credit)

Credit References (Required for Maximum Credit)

General Terms And Conditions

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