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.
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 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)
Page 1 of 4
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 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.
Page 2 of 4
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.
Page 3 of 4
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.
Page 4 of 4
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:
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
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: ____________________________________________
1573 E. Betteravia Rd., Santa Maria, Ca 93454
805-925-1369 Fax 805-925-3274
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 PROPERTY
CERTIFICATE 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 PROPERTY
CERTIFICATE 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
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signature
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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
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.
Print or type
See Specific Instructions on page 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)
a
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)
a
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
––
or
Employer 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
a
Date
a
General Instructions
Section 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)
S
peed's Oil Tool Service, Inc.
P
.O. Box 276
Santa Maria, CA 93456