I, , the Owner of &/or the Driver of Truck# , of the carrier , a licensed Motor Carrier, MC#, , and/or DOT#, ;
hereby grant authorization to Blink Transportation Ltd. to act as my agent for the sole purpose of searching for and booking shipments, processing all brokerage paperwork, and obtaining Certificates of Insurance as required in order to expedite shipments and dispatch via telephone, fax, or email for my truck.

Unit#:
License Plate#:
In the state of:

All billing, invoicing, and collections of revenue from customers, brokers, shippers, consignees, etc., are the sole responsibility of the carrier. If revenue for a shipment or shipments is uncollectible, Blink Transportation Ltd will be held harmless, and no penalty or deduction of fees will be made. The carrier agrees to maintain all proper licenses and permits to conduct business as a motor carrier in the area of intended operation. Additionally, the carrier agrees to maintain liability and cargo insurance at the amounts set forth by the home state of the carrier. Blink Transportation Ltd will be held harmless in the event of any and all claims. The carrier agrees to maintain an account with (an internet load board service), in the name of the carrier, with Blink Transportation Ltd as the point of contact for dispatching purposes.

The fee for dispatch services will be 10% of the gross revenue of each shipment with no minimum charge. (When loads are picked up) an amount equal to the above-stated percentage will be payable to: Blink Transportation Ltd.

Payments are to be conveniently paid via Chk or authorized payment with CC on file.

Please provide your SMS Cell Phone Text Number Here:

Your Email Here:

Either party has the right to end this agreement without cause at any time with fifteen (15) days’ notice by written request. Upon cancellation, any remaining balances owed will be charged to the carrier within two (2) business days without penalty.

By signing below, I fully understand the terms of this agreement.

Company:

Date:

Signature:

Print Name:

Consent *

I authorize Blink Transportation Ltd to complete all broker Carrier Packets and Rate Confirmations on my behalf.

I consent to having the Carrier Packets and Rate Confirmations completed by Blink Transportation Ltd on my behalf.

OTHER DOCUMENTS NEEDED

Please upload copies of your CDL, W9, MC Authority letter, CC authorization form, and Certificate of Insurance.