Contractor/Agent Application

Vehicle Information

Please provide current certificate of insurance for auto policy.

Work History

List two companies you have contracted with to provide delivery services.

First Contract

Dates Worked:

Second Contract

Dates Worked:

Background, Compliance & Suitability Certification
By submitting this application, the Carrier (IC vendor company) certifies that:

Carrier holds, and will maintain throughout the term of this Agreement, all required business licenses, permits, operating authority (if applicable), and insurance necessary to perform transportation services in compliance with federal, state, and local law.

1. Carrier and its personnel will comply with all applicable OTG Cargo customer requirements, including but not limited to HIPAA, Bloodborne Pathogen training, and TSA/IACSSP standards where required.

2. Carrier shall ensure that none of its owners, officers, employees, subcontractors, or drivers engaged to perform services under this Agreement have been convicted of any felony or offense that would make them unsuitable to perform transportation services, particularly those involving medical, residential, or other sensitive deliveries.

3. Carrier shall ensure that none of its owners, officers, employees, subcontractors, or drivers engaged to perform services under this Agreement are listed on any federal, state, or local sex offender registry.

4. Carrier understands and agrees that providing false or misleading information, or failing to maintain compliance with these requirements, shall constitute a material breach of this Agreement and may result in immediate termination of Carrier’s contractual relationship with OTG Cargo.

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