SUB-HAUL PACKAGEwpab389f01930a.blob.core.windows.net/.../03/SUBHAUL... · 5. Sub-hauler shall pay...

1573 E. Betteravia Rd., Santa Maria, Ca 93454 805-925-1369 Fax 805-925-3274

♦ Transfers ♦ End Dumps ♦ Portable Tanks

♦ Bottom Dump ♦ Vacuum Trucks ♦ Roll-Off Trucks

SUB-HAUL PACKAGE

Please complete, sign and return all enclosed forms and provide copies of each item as indicated below. An incomplete package/file will prevent your truck(s) from working as a sub-hauler and/or cause a delay in payment if work has already been performed.

1. [ ] Sub-Haul Information Sheet (form enclosed)

2. [ ] Sub-Haul Agreement (form enclosed)

3. [ ] DOT Verification of Maintenance records (form enclosed)

4. [ ] Copy of an enrollment certificate from a DOT approved Drug and Alcohol testing program

5. [ ] DOT Drug and Alcohol testing certification (form enclosed)

6. [ ] CHP Certificate of Compliance (form enclosed)

7. [ ] Copy of current Motor Carrier Permit

8. [ ] CARB certificate of compliance – NEW effective 1/1/2013

9. [ ] Certificate of Insurance with a minimum of $1 million in auto and general liability and Speed’s Oil Tool Service, Inc. listed as the holder and additional insured.

10. [ ] Certificate of Workers Compensation, or completed owner operator certification (form enclosed)

11. [ ] W9 – request for taxpayer ID number (form enclosed)

12. [ ] Owner Operator’s previous employment and drug and alcohol testing history (form enclosed)

13. [ ] Owner/Operator’s most current enrollment or random drug/alcohol test results.




SUB-HAUL INFORMATION SHEET

Date: _______________ CA Number: DOT Number: Name of Trucking Company: ___________________________________________________ Name of Owner/Responsible Party: _____________________________________________ Mailing Address: ______________________________________________________________ Street Address: _______________________________________________________________ City: _____________________________ State: ____________ Zip: _______________ Phone Number: ____________________ Fax Number: __________________________ E-mail Address: _______________________________________________________________ Tax ID #: _____________________________________________________________________ Type and Quantity of Equipment: Transfer(s) ______ Bottom(s) ______ End Dump(s) ______ Ten Wheeler(s) ______ Equipment Information: Truck Number: _______________________________________________________________ Truck License Plate Number: __________________________________________________ Trailer License Plate Number: _________________________________________________ (If you own more than one piece of equipment, please attach a separate sheet listing all trucks and/or trailer information)

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SUB-HAUL AGREEMENT

Prime Carrier: Speed's Oil Tool Service, Inc. P.O. Box 276 1573 E. Betteravia Rd., Santa Maria, CA 93454

CA Number: 968 US DOT Number: 612644

Sub-Hauler:

Address:

City, State, Zip Code:

CA Number:

1. Sub-Hauler, as an independent contractor, hereinafter, referred to as "Sub-Hauler" agrees to transport freight (aggregate, soil, liquid, rock, construction material, non-hazardous and hazardous waste and materials, or anything that can be legally transported) for Speed's Oil Tool Service, Inc., hereinafter referred to as "Prime Carrier", and to furnish all equipment and perform all services required for such transportation.

2. Sub-hauler shall maintain and operate its vehicles and employees at its sole expense and shall pay any and all charges arising there from including, but not restricted to labor, fuel, repairs, and any and all insurance, permits, and taxes levied or assessed, provided. However, any taxes or monies advanced by Prime Carrier on behalf of Sub-Hauler shall be immediately deducted from any amount due Sub-hauler.

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3. Sub-hauler represents and warrants that it (company or person) is engaged in the trucking business and operates truck (s) used to conduct its business, and that it will maintain said equipment in compliance with the requirements of all regulatory bodies and agencies. Sub-hauler also represents and warrants that it is the holder of all necessary and valid federal, state, county or city certificates, permits and licenses, which are required to conduct the business of transportation and trucking for hire. Sub-hauler warrants that it is enrolled in the California Highway Patrol BIT Program and the DMV Pull Notice Program. Sub-hauler will immediately notify Prime Carrier if any permits, certificates, or licenses lapse or are suspended or revoked.

4. This agreement may terminate upon thirty (30) days notice in writing being given by either party to the other. In the event of a breach thereof, and unless terminated, this agreement shall be continuous until cancelled. This agreement can only be amended or changed in writing, executed by all parties.

5. Sub-hauler shall pay all fees, licenses, taxes and fines necessary or incidental to the performance of transportation performed.

6. Sub-hauler warrants that when another company or hauler is utilized in the place of Sub-hauler, it is the Sub-haulers responsibility to have on file proper permits and insurance requirements for this Company or Owner Operator/Person. When using the substitute company/hauler, it is the Sub-hauler's responsibility to inform Prime Carrier of use on Prime Carrier's project.

7. Sub-hauler represents that it is fully protected by worker's compensation, property damage/liability insurance and will continue in effect said coverage while acting as a Sub-hauler hereunder and will furnish to Prime Carrier satisfactory evidence of such coverage at any time requested to do so by Prime Carrier and further agrees to indemnify and hold harmless Prime Carrier from any and all claims or demands of any kind except the payment of compensation due to the Sub-hauler for hauling and transportation. Sub-hauler shall name and list Prime Carrier as an additional insured under said Sub-hauler's property damage insurance policy. If any claims are made against Prime Carrier arising out of the hiring of Sub-hauler, Prime Carrier is authorized to withhold any monies due Sub-hauler until such claims are adjusted or paid by Sub-hauler to the satisfaction of Prime Carrier.

8. Prime Carrier shall notify Sub-hauler of material to be transported and of the time and location to load, all within a reasonable time prior to the required delivery time and thereafter Sub-hauler will, without delay, cause said material to be transported to the place designated by Prime Carrier or its representative.

9. Prime Carrier will furnish all shipping documents, perform billing and collecting.

10. Prime Carrier shall have no control over the vehicles, truck drivers or others used or employed by Sub-hauler provided. However, Sub-hauler agrees to employ capable and responsible employees to operate its vehicles safely and expeditiously and to maintain its vehicles so as to efficiently perform the services required.

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11. Sub-hauler is and hereby declares it to be an independent contractor and any and all employees are its employees and separate from Prime Carrier.

12. Prime Carrier agrees to pay Sub-hauler for services performed for the transportation of material a sum equal to that which is agreed upon when hired. As a condition of payments, Sub-hauler shall be responsible for the freight during the course of its transportation. Sub-hauler must complete the service agreed to be performed and it is complete only when evidenced by delivery of the clear and legible receipted bill of lading, hand tag, manifest, weight certificate, and/or other such written documents as required to the office of the Prime Carrier no later than the 3rd day following the last day of work performed on the applicable job. Any paperwork submitted AFTER the 3rd day may be subject to penalty from the Prime Carrier.

13. Sub-hauler agrees to and does hereby indemnify and save harmless Prime Carrier from any and all loss, liability, damage, or expense including reasonable attorney's fees that Prime Carrier may suffer or incur from any admission or omission of Sub-hauler.

14. Sub-hauler acknowledges that if its vehicle is to or from a treatment, storage, or disposal facility (TSDF) handling hazardous or non-hazardous waste materials, it may be working with and around substances know to have any or all of the following characteristics, among other, possible hazardous characteristics, ignitability, corrosivity, reactivity and/or toxicity. The Sub-hauler further acknowledges and agrees that transporting to and from a hazardous waste facility involves a significant responsibility to fellow workers and the public and that it abide by all rules, regulations, safety codes, training requirements, and orders of Prime Carrier while at such facilities.

15. Sub-hauler, when performing services hereunder, shall provide proper safety equipment and any other extraordinary equipment appropriate to protect themselves from harm such as, but not limited to, hard hats, goggles, gloves, protective suits, breathing apparatus, etc. The Sub-hauler and its employees and agents shall be responsible for their own safety and the Sub-hauler hereby releases and agrees to indemnify and hold Prime Carrier harmless from and against any damage to the Sub-hauler's employees or agents which may be incurred by reason of the Sub-haulers performing its services hereunder. The Sub-hauler warrants and represents that it is familiar with and will conform to Federal, State, and Local laws and regulation governing the transportation of hazardous and non-hazardous wastes.

16. Prime Carrier shall subtract from payments to Sub-hauler a 5% commission fee from each truck

ticket submitted by the Sub-hauler. Truck tickets turned into our office with incomplete or illegible

information will be subject to an additional 5% fee. Any ticket (s) received in our office more than

5 days after a job is performed will be also be assessed an additional 5% fee, per late ticket.

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Rental, Leased or Borrowed Equipment

17. Sub-hauler agrees that any trailing equipment belonging to the Prime Carrier shall be used only in connection with shipments for Prime Carrier. Prime Carrier shall subtract from payments to Sub-hauler using trailing equipment belonging to Prime Carrier a 20% equipment leasing fee, and a 5% commission fee.

18. If Sub-hauler is found to have used Prime Carrier's trailing equipment on jobs not authorized by Prime Carrier, Sub-hauler shall pay Prime Carrier a leasing fee of 25% of receipts for each day of unauthorized use.

19. Sub-hauler shall be responsible for returning trailing equipment in the same condition received with exception to normal wear and tear. Sub-hauler accepts liability for repair and/or replacement of Prime Carrier's equipment, which may be damaged or destroyed while under the control of the Sub-hauler, if loss, damage or destruction is due to the negligence of Sub-hauler or its employees or agents.

20. Sub-haulers with Prime Carrier's trailing equipment shall inspect said equipment for mechanical and safety defects. Upon acceptance of the same, Sub-hauler shall hold Prime Carrier harmless for any liabilities incurred by Sub-hauler or Sub-hauler's equipment or any other third parties as result thereof.

Prime Carrier: Speed's Oil Tool Service, Inc.

Signature:

Title:

Date:

Sub-hauler:

Signature:

Title:

Date:




VERIFICATION OF MAINTENANCE RECORDS

As directed by the DOT, CHP, and BIT programs, I/we, the undersigned, certify that all required inspection records and driver qualification records are maintained and on file at the location listed below: Company Name: _____________________________________________________________ Physical Address: ____________________________________________________________ City, State and Zip: __________________________________________________________ Telephone/Contact Number: ______________________________

Signature: _______________________________________ Printed Name: ___________________________________ Date: ____________________________________________


DRUG AND ALCOHOL TESTING CERTIFICATION

This is to certify that I/We, the undersigned, am/are currently enrolled in a DOT approved drug and alcohol-testing program for the purpose of pre-employment, random, and post-accident drug and alcohol testing. (Include a copy of enrollment certificate) I/We will notify Speed's Oil Tool Service, Inc. if and when my/our current enrollment expires or if I enroll with another company. Hauler:

Signature:

Print Name:

Title:

Date:

If not enrolled in a DOT approved testing program, list or describe the means of compliance:

MOTOR CARRIER OF PROPERTYCERTIFICATE OF COMPLIANCE

STATE OF CALIFORNIA

DEPARTMENT OF CALIFORNIA HIGHWAY PATROL

One copy of this certificate shall be provided to the person for whom services are provided (the contracting motor carrier); one copy shall be

retained by the motor carrier of property (the contracted motor carrier). Copies shall be retained by both parties for the duration of the contract

or period of service plus two years, and shall be presented for inspection upon the request of an authorized employee of the California Highway

Patrol or the Department of Motor Vehicles.

(Contracting Carrier's Name)Services Provided For:

I, the undersigned, certify that

holds a Motor Carrier of Property Permit, Number , which is valid through ,

a copy of which is attached. I further certify that I, or a company officer, will immediately notify users of this company's services if the permit is

suspended, revoked, or is otherwise rendered invalid.

(Contracted Carrier's Name)

(CA Number) (Date)

Printed Name

California Driver's License Number

Signature

Title

Date

CHP 809 (Rev. 2-98) OPI 062

c809_298.frp

MOTOR CARRIER OF PROPERTYCERTIFICATE OF COMPLIANCE

STATE OF CALIFORNIA

DEPARTMENT OF CALIFORNIA HIGHWAY PATROL

One copy of this certificate shall be provided to the person for whom services are provided (the contracting motor carrier); one copy shall be

retained by the motor carrier of property (the contracted motor carrier). Copies shall be retained by both parties for the duration of the contract

or period of service plus two years, and shall be presented for inspection upon the request of an authorized employee of the California Highway

Patrol or the Department of Motor Vehicles.

(Contracting Carrier's Name)Services Provided For:

I, the undersigned, certify that

holds a Motor Carrier of Property Permit, Number , which is valid through ,

a copy of which is attached. I further certify that I, or a company officer, will immediately notify users of this company's services if the permit is

suspended, revoked, or is otherwise rendered invalid.

(Contracted Carrier's Name)

(CA Number) (Date)

Printed Name

California Driver's License Number

Signature

Title

Date

CHP 809 (Rev. 2-98) OPI 062

c809_298.frp

CHERYL

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CERTIFICATION REGARDING WORKERS’ COMPENSATION

I hereby certify that I _____________________________________________, Name of Sub-hauler

Hereinafter referred to as “Sub-hauler”, is a sole proprietorship (owner/operator) and will not hire any employees to perform work while working as a Sub-hauler for Speed’s Oil Tool Service, Inc., whom workers’ compensation coverage is required. Further, Sub-hauler agrees to hold harmless and defend Speed’s Oil Tool Service, Inc. for and against any claims, demands, suits or damages asserted by any person under the workers’ compensation laws of the state of jurisdiction herein. In the event Sub-hauler for any reason hires an employee during any project while representing Speed’s Oil Tool Service, Inc., Sub-hauler agrees to comply with the Workers’ Compensation Insurance requirements set forth by the State of California, and notify Speed’s Oil Tool Service, Inc. with a certificate of such coverage. Date: _________________________ Owner/Operator Signature: ______________________________________________________ Company Name: ________________________________________________________________

Form W-9(Rev. December 2014)Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Give Form to the

requester. Do not

send to the IRS.

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2.

1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

2 Business name/disregarded entity name, if different from above

3 Check appropriate box for federal tax classification; check only one of the following seven boxes:

Individual/sole proprietor or single-member LLC

C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)

Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner.

Other (see instructions)

4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):Exempt payee code (if any)

Exemption from FATCA reporting

code (if any)(Applies to accounts maintained outside the U.S.)

5 Address (number, street, and apt. or suite no.)

6 City, state, and ZIP code

Requester’s name and address (optional)

7 List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter.

Social security number

– –

orEmployer identification number

–

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3.

Sign Here

Signature of

U.S. person Date

General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.

Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.irs.gov/fw9.

Purpose of Form

An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following:

• Form 1099-INT (interest earned or paid)

• Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2.

By signing the filled-out form, you:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and

4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information.

Cat. No. 10231X Form W-9 (Rev. 12-2014)

Speed's Oil Tool Service, Inc.P.O. Box 276Santa Maria, CA 93456

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