Truck Based Transportation will need the following list of items to add you to our list of approved carriers.

Prospective Carrier,

Truck Based Transportation will need the following list of items to add you to our list of

approved carriers.

Please return the following information in person, fax or mail in order to be placed on active

carrier status.

__________ Carrier profile to include equipment list.

__________ Copy of carrier’s registration/operating authority & D.O.T. safety rating

review (FMCSA)

__________ Completed form W-9 & Identification

__________ Cargo insurance certificate naming Truck Based Transportation as

certificate holder with $100,000 cargo (excluding sand & gravel)

__________ Liability insurance certificates naming Truck Based Transportation

As holder with $1,000,000 coverage (transport of goods)

__________ Liability insurance certificate naming Truck Based Transportation

As holder with $500,000 coverage for (sand & gravel carriers).

Carrier Information Sheet

Do you haul Out of Bridgeport? Yes No

Truck Information

Aluminum/Light Weight = Alum Round Bottom/Heavy Duty = Demo Belly Dump = BD Tandem/Truck = T&P Tandem/Dump= TDM

Owner Operator Agreement Certificate of Additional Insured Liability

W9 Driver’s License

Completed By: ____________________________________ Date: _________________________

Name: Date:

Company Name (if applicable): Address:

City: State: Zip Code:

Phone Number: Email:

US DOT Number: TX DOT Number:

Truck Based Transportation

Transportation Brokerage Agreement

This Agreement is entered into this ______, day of _______, 2_____, by and between Truck Based

Transportation Southlake, Texas (“BROKER”), a Registered Property Broker, MC-908522, and

________________________________________, a Registered Motor Carrier, Permit/Certificate No. DOT-___________ (“CARRIER”). BROKER and CARRIER may be collectively referred to as the “Parties.” (“Registered” means operated under authority issued by the Federal Motor Carrier Safety Administration (“FMCSA”) or its predecessors within the U.S. Department of Transportation).

1. CARRIER WARRANTIES AND REPRESENTATIONS.

CARRIER represents and warrants that:

1.1. CARRIER is a Registered Motor Carrier of Property authorized to provide transportation of property under contracts with shippers and receivers and/or brokers of general commodities.

1.2. CARRIER shall transport the property, under its own operations authority identified above, and not under the authority of any other Motor carrier, and subject to the terms of the Agreement.

1.3. CARRIER agrees that a Shipper’s insertion of BROKER’s name as the carrier on a bill of lading is erroneous, shall be corrected by CARRIER, and if not corrected, shall be for the Shipper’s convenience only and shall not change BROKER’s status as a property broker, nor shall it change CARRIER’s status as a motor carrier.

1.4. CARRIER shall commingle commodities only in accordance with DOT regulations. 1.5. CARRIER will not re-broker, co-broker, subcontract, assign, interline, or transfer the

shipments hereunder, without prior written consent of BROKER. If CARRIER breaches this provision, BROKER shall have the right of paying the monies it owes CARRIER directly to the Delivering Carrier, in lieu of payment to CARRIER. CARRIER shall not be released from any liability under this Agreement. CARRIER will be liable for consequential damages for violation of this Paragraph.

1.6. CARRIER is in compliance, and shall maintain compliance during the term of this Agreement, with all applicable federal, state, provincial and local laws relating to the provision of its services including, but not limited to: transportation of Hazardous Materials, (including the licensing and training of drivers), as defined in 49 C.F.R §172.800, §173, and §397 et seq. to the extent that any shipments hereunder constitute Hazardous materials; security regulations; owner/operator lease regulations; loading and securement of freight regulations; implementation and maintenance of driver safety regulations including, but not limited to, hiring, controlled substances, and hours of service regulations; sanitation, temperature, and contamination requirements for transporting food, perishable, and other products; qualifications and licensing and training of drivers; implantation and maintenance of equipment safety regulations; maintenance and control of the means and method of transportation including, but not limited to, performance of its drivers; and all applicable insurance laws and regulations, including, but not limited to, workers’ compensation.

1.7. To the extent that any shipments subject to this Agreement are transported within the State of Texas and surrounding states will meet the equipment requirements of those operations.

1.8. CARRIER is solely responsible for any and all management, governing, discipline, direction and control of its employees, owner/operators, and equipment with respect to operating within all applicable federal and state legal and regulatory requirements to ensure the safe operation of CARRIER’s vehicles, drivers and facilities. CARRIER further warrants that safe and legal operation of the CARRIER and its drivers shall completely and without question govern and supersede any service requests, demands, preferences, instructions, or information from BROKER or BROKER’s customer(s) with respect to any shipment at any time.

1.9. CARRIER will notify BROKER immediately if its federal Operating Authority is revoked, suspended or rendered inactive for any reason; and/or if it is sold as an entity or in the case of an asset purchase involving a significant percentage of the company’s assets, or if there is a change in control of ownership, and/or any insurance required hereunder is threatened to be or is terminated, cancelled, suspended, or revoked for any reason.

1.10. CARRIER understands it may transport temperature controlled goods and represents and warrants that when such loads are accepted, CARRIER is experienced in transporting temperature controlled products and understands that delivery time requirements and temperature specifications are critical.

1.11. CARRIER shall provide broker with immediate notice of any alleged or actual circumstances that may have caused, contributed to, or resulted in rejection by the consignee or freight damage or loss. Notice shall be provided by telephone, fax, and/or email.

1.12. CARRIER shall comply with shipper seal requirements communicated to CARRIER on any rate confirmation, bill of lading, or otherwise.

1.13. CARRIER does not have an “unsatisfactory” or “conditional” safety rating issued by the FMCSA. CARRIER will notify BROKER in writing immediately if its safety rating is changed “unsatisfactory” or “conditional.”

1.14. CARRIER authorizes BROKER to invoice CARRIER’s freight charges to shipper, consignee, or third parties responsible for payment.

1.15. CARRIER has investigated, monitored, and agrees to conduct business hereunder based on the credit-worthiness of BROKER and is granting BROKER credit terms accordingly.

2. BROKER RESPONSIBILITIES.

2.1. SHIPMENTS. BROKER agrees to solicit and make efforts to obtain freight transportation business for CARRIER to the mutual benefit of CARRIER and BROKER, and shall offer CARRIER at least one (1) load/shipment annually. BROKER shall inform CARRIER of (a) the place of origin and destination of all shipments; and (b) if applicable, any special shipping instructions or special equipment requirements, of which BROKER has been timely notified by shipper.

2.2. BILLING. BROKER agrees to conduct all billing services to shippers or other party responsible for payment. CARRIER shall invoice BROKER for its (CARRIER’S) charges, as mutually agreed in writing, by fax, or by electronic means, contained in BROKER’s Rate Confirmation Sheet(s), which are incorporated herein by reference. 2.3. RATES. Additionally, any rates, which may be verbally agreed upon, shall be deemed

confirmed in writing where CARRIER has billed the agreed rate and BROKER had paid it. All written confirmations or rates, including confirmations by billing and payment, shall be incorporated herein by this reference. Rates or charges, including but not limited to stop-offs, detention, loading or unloading, fuel surcharges, or other accessorial charges, released rates or values, or tariff rules or circulars.

2.4. PAYMENT. The Parties agree that BROKER is the sole party responsible for payment of CARRIER’s charges. Failure of BROKER to collect payment from its customer shall not exonerate BROKER of its obligation to pay CARRIER. BROKER agrees to pay CARRIER’s undisputed invoice within 30 days of receipt of a legible copy of the bill of lading, signed Rate Confirmation Sheet, and any and all other documents pertaining to the load reasonably required by BROKER, provided CARRIER is not in default under the terms of the Agreement.

2.5. SURETY BOND. BROKER shall maintain a surety bond/trust fund as required by law and on file with the FMCSA in the form and amount not less than that required by that agency’s regulations.

2.6. SCOPE. BROKER’s responsibility is limited to arranging for, but not actually performing, transportation of a shipper’s freight.

3. CARRIER RESPONSIBILITIES.

3.1. EQUIPMENT AND PERSONNEL. Subject to its representations and warranties herein, CARRIER agrees to provide the necessary equipment and qualified personnel for completion of the transportation services required for BROKER and/or its customers. CARRIER will not supply equipment that has been used to transport hazardous wastes, solid, or liquid, regardless of whether they meet the definition in 40 C.F.R. § 261.1 et. seq. CARRIER agrees that all shipments will be transported and delivered timely as required by shipper or BROKER. When transporting temperature controlled goods. 3.2. BILLS OF LADING. CARRIER shall sign a bill of lading in compliance with 49 C.F.R. §373.101 (and any amendments thereto), for the property it receives for transportation under the Agreement, and CARRIER shall clearly identify itself as the CARRIER on the bill of lading. Unless otherwise agreed in writing, CARRIER shall become fully responsible/liable for the freight when it takes/ receives possession thereof, and the trailer(s) is/are loaded, regardless of whether a bill of lading has been issued, and/or signed, and/or delivered to CARRIER, and which responsibility/liability shall continue until delivery.

3.3. LOSS & DAMAGE CLAIMS.

3.3.1. CARRIER shall comply with 49 C.F.R. § 370.1 et seq. and any amendments and/or any other applicable regulations adopted by the Federal Motor Carrier Safety Administration, U.S.

3.3.2. CARRIER’s liability for any cargo damage, loss, or theft from any cause shall be determined under, 49 U.S.C. §14706.

3.3.3. CARRIER’s indemnification liability herein for freight loss and damage claims shall include legal fees which shall constitute special damages, the risk of which is expressly assumed by CARRIER, under 3.3.2 above.

3.3.4. Except as provided herein, neither Party shall be liable to the other for consequential damages without prior written notification of the risk of loss and its approximate financial amount, and agreement to assume such responsibility in writing. Loss or damages arising out of delayed delivery, failed delivery, or failure to maintain required temperatures of temperature controlled shipments shall not constitute consequential damages but fall within the categories of damages covered by the Indemnity provisions found at Paragraph 3.5 and elsewhere herein.

3.3.5. Notwithstanding the terms of 49 C.F.R. 370.9, BROKER, acting as a facilitator for BROKER’S shipper customer, will submit freight loss and damage claims in compliance with 49 CFR 370.1 et seq. to CARRIER within 12 months of delivery date or scheduled delivery whichever is later. CARRIER shall pay, decline or make settlement offer in writing on all cargo loss and damage claims within 30 days of receipt of the

claim. Failure of CARRIER to pay, decline or offer settlement within this 30 day period shall be deemed admission by CARRIER of full liability for the amount claimed and a material breach of the Agreement.

3.3.6. CARRIER shall not sell, auction, or otherwise salvage or dispose of any allegedly damaged or compromised shipment without the prior written consent of BROKER or the shipper.

3.4. INSURANCE. CARRIER is responsible for its own insurance in accordance with federal law, and shall provide evidence to BROKER of coverage for CARRIER by furnishing BROKER with Certificate(s) of Insurance, or insurance policies providing thirty (30) days advance written notice of cancellation or termination, and unless otherwise agreed, subject to the following minimum limits: Public liability $1,000,000.00; motor vehicle (including hired and non-owned vehicles), $1,000,000.00 while transporting sand and gravel shipments within the state of Texas carriers shall hold $500,000.00 in liability. Cargo damage/loss $100,000.00 excluding (sand and gravel) workers’ compensation, insurance for CARRIER’S employees or equivalent per the law. 3.5. INDEMNITY. CARRIER shall defend, indemnify and hold BROKER and its shipper customer harmless from any and all losses, claims, actions, suits, demands, or damages arising out of or related to CARRIER’S acts, omissions, performance, or breach of any warranty, representation or obligation under this Agreement.

3.6. RIGHTS. CARRIER automatically assigns to BROKER all its rights to collect freight charges from Shipper or any other responsible third party on receipt of payment from BROKER.

3.7. TAXES AND EMPLOYMENT OBLIGATIONS. CARRIER assumes full responsibility and liability for payment of the following items: All applicable federal, state, and local payroll taxes, taxes for unemployment insurance and SSI.

4. MISCELLANEOUS.

4.1. INDEPENDENT CONTRACTOR. It is understood and agreed that the relationship between BROKER and CARRIER is that of independent contractor and that no employer/employee relationship exists, or is intended. BROKER has no control of any kind over CARRIER.

4.2. NON-EXCLUSIVE AGREEMENT. CARRIER and BROKER acknowledge and agree that this contract does not bind the respective Parties to exclusive services to each other. Either party may enter into similar agreements with other carriers, brokers, or freight forwarders.

4.3. WAIVER OF PROVISIONS.

4.3.1. Failure of either Party to enforce a breach or waiver of any provision or term of this Agreement shall not be deemed to constitute a waiver of any subsequent failure or breach, and shall not affect or limit the right of either Party to thereafter enforce such a term or provision.

4.3.2. This Agreement is for specified services pursuant to 49 U.S.C. § 14101(b). To the extent that terms and conditions herein are inconsistent with part (b) Subtitle IV, of Title 49 U.S.C., the Parties expressly waive all rights and remedies they may have under the Act.

4.3.3. Venue, controlling law, and jurisdiction in any legal proceedings under this Agreement shall be in the State of Texas, Wise County.

4.4. BROKER’S ACCOUNTS. Except as otherwise agreed to in writing by BROKER: (1) During the term of the Agreement, and for a period of 18 months following termination of this Agreement, CARRIER agrees not to solicit business from, nor perform any transportation related services directly or indirectly on behalf of any of BROKER’s customers first introduced to it by BROKER, or through the performance of this Agreement. However, if CARRIER conducted business with BROKER’s customers within one year prior to entering into this Agreement, then CARRIER can continue to solicit those lanes previously served. (Truck lanes) for purposes of this Agreement shall mean origination locations to destination locations for both truckload and Materials shipments." “Broker’s customers” for purposes of this Agreement shall mean any shipper, consignee or other party responsible for payment, for whom BROKER provided transportation services and was billed for those services.

4.5. CONFIDENTIALITY.

4.5.1. In addition to Confidential Information protected by law, statutory or otherwise, the Parties agree that all of their financial and other proprietary, confidential, or sensitive information and that of their customers, including but not limited to freight and brokerage rates, amounts received for brokerage services, amounts of freight charges collected, freight volume requirements, as well as personal customer information, customer shipping or other logistics requirements, that is shared or learned between the Parties and their customers, shall be treated as confidential, and shall not be disclosed or used for any reason without prior written consent.

4.6. NOTICES. All notices provided or required by this Agreement, shall be made in writing and delivered, return receipt requested, to the addresses shown herein with postage prepaid, by confirmed (electronically acknowledged on paper) fax, in person or by email. 4.7. CONTRACT TERM. The term of this Agreement shall be one (1) year from the date

hereof and thereafter it shall automatically be renewed for successive one-year periods, unless terminated, upon thirty (30) days prior written notice, with or without cause, by either Party at any time.

Truck Based Transportation

Broker Carrier Agreement Form 2015

Date: Company Officer Signature (Sign)

Howard

Weisberg

Phone: Fax: Carrier Authorized Signature (Sign) (Print) Title: Company Address: