Rev. 01/01/11

REQUIREMENTS TO BE ESTABLISHED AS A CARRIER

WITH THE ALLEN LUND COMPANY, INC.

1. NEW CARRIER INFO SHEET: Must be filled out completely.

2. COPY OF YOUR MC AUTHORITY

3. W-9

• Must include tax ID# or SS# (whatever number you use to claim your taxes.)

• Must check off type of business – individual/sole proprietor, corporation, partnership, or other.

• Must have the EXEMPT (from backup withholding) box checked off if you are Exempt.

4. POLICY STATEMENT: Read and sign bottom.

5. CARRIER AND BROKER AGREEMENT: Complete 1st page with name of

company, date, and MC#. Initial each page. Completely fill out page 6 and sign. Please return all 6 pages of the contract. FIRST AND LAST NAME REQUIRED.

6. INSURANCE CERTIFICATE: Must have Cargo and Auto Liability insurance

with Allen Lund as certificate holder. General Liability is not currently a requirement, but may qualify you for more loads.

7. Certificate holder address should read:

Allen Lund Company, Inc.

P.O. Box 1369 La Cañada, CA 91012

Feel free to contact Carrier Resources with any questions or concerns you may have. Carrier Resources Phone: 800.811.0083 Fax: 888.518.5863 E-mail: carrierresources@allenlund.com

July 9, 2012

ALLEN LUND COMPANY, INC.

New Carrier Information Which ALC office referred you? Date: ________________

Company Information

Company Name FED ID ___________ DOT#________________________ MC#_______________________________ ISSUE DATE__________________________________ Company E-mail________________________________@_____________________________________

Physical Address:

Address_________________________________________ City ____________________________ State _______ ZIP _____________

Phone # 800 # Fax # Company Owner Dispatcher E-mail Dispatcher E-mail

Factoring: Yes No (If yes, please enter Factoring information below)

Remit to Address/Factoring Information:

Factoring Company______________________________________________________Phone #

Address_________________________________________ City ____________________________ State _______ ZIP _____________

Insurance Information

Insurance Agent Agent’s Phone # Fax # E-mail Cargo Expiration Date Cargo Amount $ Liability Exp. Date Liability Amount $

Fuel Advances/Quick Pay

Will your company request FUEL ADVANCES (ComCheks)? Yes No* Will your company request QUICK PAY settlements (ComCheks)? Yes No Are there any restrictions on ComCheks? Yes No If “Yes” what are those restrictions? *If you choose not to request Fuel Advances, no ComCheks will be issued*

July 9, 2012

NOTE: If your company requests an advance and you are factoring, you must provide Allen Lund Company a release letter, or the advance will not be issued. The release letter must come directly from the factoring company, be on the factoring company’s letterhead, and be signed by the factoring company. ALC will endeavor to recognize any limitations requested above.

References

1 Company Name ___________________________________________ Contact ______________________________ Phone # ___________

2 Company Name ___________________________________________ Contact ______________________________ Phone # ___________

3 Company Name ___________________________________________ Contact ______________________________ Phone # ___________

Equipment

Type & No. of Trucks: Flatbed Van Refrigerated Team Service: Yes No Hazmat: Yes No Satellite Tracking: Yes No Air-Ride: Yes No Do you/ your drivers have a TWIC ID Card: Yes No Can you provide service to/from Mexico: Yes No to/from Canada: Yes No____ ___ Please fax or email your completed Carrier Setup Packet to the _______________________________ office. Fax #: _________________ Email: _________________ If you have any questions regarding the requested information please call _________________

Rev. 01/01/11

ALLEN LUND COMPANY, INC.

Policy Statement

Quick Pay / Advance Policy: There will be a charge for all advances and / or advance settlements (quick-pay) as follows:

1. Fee for advance is 2% of the rate or $25.00, whichever is higher. 2. Fee for an advance settlement (quick-pay) upon delivery is 2% of the settlement

amount or $25.00, whichever is higher. 3. The Allen Lund Company, Inc. must receive all required information before final

payment will be release.

Payment Policy: Direct deposit (ACH) is Allen Lund Company, Inc’s preferred method of payment.

Every effort will be made to pay carrier invoices within 14 days of invoice receipt, provided the bills include the following:

1. They are clearly signed. 2. All copies are legible. 3. No notice of claim has been given. 4. A signed confirmation has been returned. 5. Invoice is mailed, faxed, or e-mailed to the appropriate Allen Lund Company, Inc.

office.

Upon setup you will be assigned a username and password to view load board on allenlund.com

Acknowledgement of policy:

Signed_________________________________________Date___________________

Name of Company_______________________________________

Rev. 01/01/11

Certification of Ownership Affidavit &

Minority Report

Dear Valued Carriers: At the request of some of our shippers, we are seeking the verification of the business status for all carriers. Signature of the undersigned document affirms that the statements are true and correct and include all material information necessary to identify and explain the operations of your company, ____________________________________ , as well as the ownership status. Your company also affirms that the key principal outline below has majority interest in the business, which constitutes majority control of the daily business operations. Please complete the following ownership information. Key principal or owner: ________________________________________________ Legal company address: ________________________________________________ City, State, Zip code: ________________________________________________ E-mail address: ________________________________________________ Ownership: Please circle appropriate classification:

African American: Male Female | Are you a certified Minority? Asian American: Male Female | Yes [ ] No [ ] Latin American: Male Female | (visit www.mwbe-enterprises.com Native American: Male Female | for information) (American Indian, Aleuts, Eskimo, Native Hawaiian) | Cert No._______________ Caucasian American Male Female | Exp. Date_____________ (At least 51% owned, controlled & managed by a person of Anglo or European descent) Other: _______________________ Male Female

Are you a SmartWay Transportation Partner? Yes [ ] No [ ]

Are you TWIC compliant? Yes [ ] No [ ]

If for reasons of privacy, you do not wish to provide this information, check here ___ (This will have no effect on your relationship with the Allen Lund Company, Inc.)

All information submitted will remain in our files and become the property of Allen Lund Company, Inc. Information that reasonably may be regarded as sensitive will be considered proprietary and confidential. Should the ownership of your company change through merger, acquisition, or change due to death of the principal, please contact us within 30 days to update our records. Name of Business: _______________________________________________________ Signature: _ _____________________________________Date: __________________ Name (print): __________________________ Title: ___________________________

Rev. 01/01/11

Get paid up to 5 days *FASTER! FREE!Signing up for Direct Deposit does not stop you from receiving Quick Pay

DIRECT DEPOSIT (ACH) REQUESTFill out the information below to authorize automatic deposit and return the completed form with a VOIDED CHECK to the Allen Lund Company, Carrier Resources Department. Please allow approximately 15 working days for your automatic deposit to become effective.

Company Name: Federal Tax ID# / SS#:

Company Phone Number: Remittance E-mail:

Remit to company name if different from company name listed above (i.e. factoring company):

Street Address Line 1: Contact:

Line 2: Contact Phone Number:

City: State/Province: Country: Postal Code:

Beneficiary Account Name: Type of Account (SELECT ONE):� Checking � Savings

Beneficiary Account Number (DDA): Routing (ABA) Number:

Banking Institution’s Name: Banking Institution Phone Number:

City: State/Province: Country: Postal Code:

I authorize you and the banking institution listed to deposit funds automatically to the account. If funds to which I am not entitled are deposited to this account, I authorize you to direct the banking institution to return said funds. This authority will remain in effect until I have cancelled it in writing.

________________________________________ ______________________________________Print Name of Approver Signature of Approver (required)

________________________________________ ________________ _________________Approving Officer Title MC Number Date Options for submission of this form:

• Email to direct-deposit@allenlund.com• Fax completed request with relevant attachments to (888) 518-5863• Mail hard copy to: Allen Lund Company, Attention: Carrier Resources, P.O. Box 1369,

La Cañada, CA 91012• Note: Direct Deposit is Net 14 Day pay• Email address required to notify you of your payment

*Eliminates mail time