AGREEMENT WITH US

We Believe on Providing Best Services to Our Customers as Per Commitment

CARRIER AGREEMENT WITH US

Company Name

Physical Address

City

State/ Province

Postal / Zip Code

Phone #

MC#

DOT#

Truck Type

Weight Limit

Truck Length

Payment Agreed ($)

Date:

Attach MC Authority Letter, Notice of Assignement (NOA), Certificate of Insurance (COI) & W9 Form

I Hereby authorize GRASSEL SERVICES LLC to furnish my given the information in the form to the Brokerage companies or where ever required as per instruction of FMCSA / DOT during load booking/ delivery of the freight or after that if required for payment options as well. They are authorized to use this data to provide our company dispatch services against the mentioned payment package which we will pay them every week after as we get the payments of the delivered load. GRASSEL SERVICES LLC will be responsible to find the best paying load options for our truck (s). They will also do paperwork, phone calls to Brokers sometimes shippers and receiver as well.

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GRASSEL BENJAMIN TERRY 3108 ELLIS AVE LAKELAND, FL 33803