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Published by jordan, 2016-12-21 21:24:54

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MEMBERSHIP APPLICATIONAPPLICANT: MR. MRS. MS. LAST FIRST MIDDLEADDRESS: STREET APT/STE CITY STATE ZIP(PHYSICAL)ADDRESS: STREET APT/STE CITY STATE ZIP(MAILING)PHONE #: ( ) HOME CELL OTHERPHONE #: ( ) HOME CELL OTHER @E-MAIL: NO EMAILDO YOU OWN YOUR OWN COMPANY? YES NOIF “YES”, ENTER NAME HERE:I HEREBY APPLY FOR MEMBERSHIP IN THE NATIONAL ASSOCIATION OF INDEPENDENT TRUCKERS, LLC (“NAIT”)AND AGREE TO PAY MONTHLY MEMBERSHIP DUES DISCLOSED AT www.naitusa.com.I UNDERSTAND MEMBERSHIP IS NONTRANSFERABLE.SUBMISSION OF THIS APPLICATION FOR MEMBERSHIP AUTHORIZES NAIT AND ITS AFFILIATED BENEFIT PROVIDERS TO CONTACT MEOR MY COMPANY BY MAIL, PHONE, FAX OR E-MAIL REGARDING NAIT MEMBERSHIP AND MEMBER BENEFITS.SIGNATURE: DATE:RETURN TO:MAIL: PO BOX 901606, KANSAS CITY, MO 64190E-MAIL: [email protected]: (816) 713-1333 FOR ADDITIONAL INFORMATION ON YOUR TOTAL BENEFIT PACKAGE VISIT www.naitusa.com OR CALL (800) 821-8014 Follow us on Twitter: @naitusa018019 3/15

Motor Vehicles Driver’s CERTIFICATION OF COMPLIANCE WITH DRIVER LICENSE REQUIREMENTSMOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates inintrastate, interstate, or foreign commerce and operates a vehicle weighing 26,001 pounds or more, can transportmore than 15 people, or transports hazardous materials that require placarding.The requirements in Part 391 apply to every driver who operates in interstate commerce and operates a vehicleweighing 10,001 pounds or more, can transport more than 15 people, or transports hazardous materials that requireplacarding.DRIVER REQUIREMENTS: Parts 383 and 391 of the Federal Motor Carrier Safety Regulations contain somerequirements that you as a driver must comply with. These requirements are in effect as of July 1, 1987. They areas follows: 1) POSSESS ONLY ONE LICENSE: You, as a commercial vehicle driver, may not possess more than one motor vehicle operator’s license. If you have more than one license, keep the license from your state of residence and return the additional licenses to the states that issued them. DESTROYING a license does not close the record in the state that issued it; you must notify the state. If a multiple license has been lost, stolen, or destroyed, close your record by notifying the state of issuance that you no longer want to be licensed by that state. 2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION: Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver’s license. In addition, Section 383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (If the violation occurs in a state other than the one which issued your license). The notification to both the employer and state must be in writing.The following license is the only one I will possess: State Exp. DateDriver's License No.DRIVER CERTIFICATION: I certify that I have read and understood the above requirements.Driver's Name (Printed):Driver’s Signature:_______________________________________ Date________________________Notes:(This form is not required for DOT compliance) 90-F 1617© Copyright 2000 J.J. KELLER & ASSOCIATES, INC., Neenah, WI • USA • (800) 327-6868 • www.jjkeller.com • Printed in the United States (Rev. 10/00)

APPLICANT CONSENT AND RELEASE FORMCOMPANY NAME: ________________________________________________________________ADDRESS:____________________________________________ ZIP _____________PHONE NO.: ______________________________________________________________________ In consideration for my being considered for employment, I, ____________________________ ,hereby give my consent to and authorize ________________________________________________the employer, to perform any testing or medical procedures necessary to determine the presence ofalcohol or drugs in my body.I further give my consent to release to __________________________________________________or its designated agents, the results of any medical test performed, including any test or medicalprocedures to determine the level or presence of alcohol or drugs.I realize that my refusal to sign this form constitutes a violation of the employer's stated policy, andfor that refusal, I will not be considered for, and knowingly waive any possibility of employment.I understand this consent and release shall be valid for my length of employment and that a copy ofthis consent form shall be valid as an original._______________________________________ _________________________Applicant Signature Date_______________________________________ _________________________Witness Signature Date(Suggest you have your attorney look at and approve before using) 

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PRE-EMPLOYMENT URINALYSIS NOTIFICATION The Federal Motor Carrier Safety Regulations, Section 391.103 Pre-Employment Testing Requirements, applyto driver applicants of this company. 391.103 PRE-EMPLOYMENT TESTING REQUIREMENTS. (a) A motor carrier shall require a driver-applicant who the motor carrier intends to hire or use pre-qualificationcondition. (b) A driver-applicant shall submit to controlled substance testing as a pre-qualification condition. (c) Prior to collection of the urine sample under FMCSR 391.107 of this subpart, a driver-applicant shall benotified that the sample will be tested for the presence of controlled substances. As a condition of employment, I agree to the urine sample collection and controlled substance testing. I understand a positive test for controlled substances based on the Urinalysis Test will medically disqualify mefrom the operation of a commercial motor vehicle for this company. The Medical Review Officer will maintain the results of the Urinalysis Test. Negative and Positive results willbe reported to the company. My written authorization is required for the Urinalysis Tests to be given to other parties. I have read and understand the above conditions for the Pre-Employment Urinalysis Notification._______________________________Applicant’s Name_______________________________ ______________________Applicant’s Signature Date Witnessed By:_______________________________ ______________________Company Representative Date

DRIVER'S APPLICATION FOR EMPLOYMENTCompany State ZipAddressCity (answer all questions-please print)In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positionswithout regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any otherprotected group status. Date of ApplicationPosition Applied forNameList your addresses of residency for the past 3 years. City PhoneCurrent Address State & Zip Code State & Zip Code Street State & Zip CodePrevious State Zip Code How Long?Addresses Street City yr./mo Street City How Long? Street City yr./mo How Long? yr./mo How Long? yr./moDo you have the legal right to work in the United States?Date of Birth Can you provide proof of age? Where?(Required for Commercial Drivers)Have you worked for this company before?Dates: From To Rate of Pay PositionReason for leavingAre you now employed? If not, how long since leaving your last employment?Who referred you? Rate of pay expected?Have you ever been bonded? Name of bonding company?Have you ever been convicted of a felony?If yes, please explain fully on a separate sheet of paper. Conviction of a crime is not an automatic bar to employment-allcircumstances will be considered.Emergency Contact Person RELATIONSHIP PHONE NUMBER NAME© Copyright 1998 J. J. KELLER & ASSOCIATES, INC., Neenah, WI • USA This form is made available with the understanding that J. J. Keller & Associates, Inc. is not engaged in rendering legal, 15F (Rev. 5/0629)1 (800) 327-6868 • Printed in the United States accounting, or other professional services. J. J. Keller & Associates, Inc. assumes no responsibility for the use of this form, or any decision made by an employer which may violate local, state, or federal law.

EMPLOYMENT HISTORY All applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. Listcomplete mailing address, street number, city, state and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years information onthose employers for whom the applicant operated such vehicle.(Note: List employers in reverse order starting with the most recent. Add another sheet as necessary.) EMPLOYER DATE FROM TONAME POSITION HELDADDRESSCITY STATE ZIP CODE SALARY/WAGECONTACT PERSON PHONE #DID YOU DRIVE A VEHICLE REQUIRING A CDL? REASON FOR LEAVING YES NO EMPLOYER DATE FROM TONAMEADDRESS POSITION HELD SALARY/WAGECITY STATE ZIP CODECONTACT PERSON PHONE # REASON FOR LEAVINGDID YOU DRIVE A VEHICLE REQUIRING A CDL? YES NO EMPLOYER DATE FROM TONAMEADDRESS POSITION HELDCITY STATE ZIP CODE SALARY/WAGECONTACT PERSON PHONE # REASON FOR LEAVINGDID YOU DRIVE A VEHICLE REQUIRING A CDL? YES NO EMPLOYER DATE FROM TONAMEADDRESS POSITION HELDCITY STATE ZIP CODE SALARY/WAGECONTACT PERSON PHONE # REASON FOR LEAVINGDID YOU DRIVE A VEHICLE REQUIRING A CDL? YES NO* Includes vehicles having a GVWR of 26,001 lbs or more, vehicles designed to transport 15 or more passengers, or any size vehicleused to transport hazardous materials in a quantity requiring placarding.PAGE 2 15F (Rev. 5/02) 691

ACCIDENT RECORD FOR THE PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED) IF NONE, WRITE NONE DATES NATURE OF ACCIDENT FATALITIES INJURIES (HEAD-ON, REAR-END, UPSET, ETC.)LAST ACCIDENTNEXT PREVIOUSNEXT PREVIOUSTRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE NONELOCATION DATE CHARGE PENALTY (ATTACH SHEET IF MORE SPACE IS NEEDED) EDUCATIONCHECK HIGHEST GRADE COMPLETED: 1 2 3 4 5 6 7 8 HIGH SCHOOL: 1 2 3 4 COLLEGE: 1 2 3 4LAST SCHOOL ATTENDED (CITY) EXPERIENCE AND QUALIFICATIONS - DRIVER (NAME) STATE LICENSE NO. TYPE EXPIRATION DATE DRIVERLICENSESA. Have you ever been denied a license, permit or privilege to operate a motor vehicle? YES NO NOB. Has any license, permit or privilege ever been suspended or revoked? YESIF THE ANSWER TO EITHER A OR B IS YES, GIVE DETAILS BELOWDRIVING EXPERIENCE CHECK ALL THAT APPLY CLASS OF EQUIPMENT TYPE OF EQUIPMENT DATES APPROX. NO. OF MILES (VAN, TANK, FLAT, ETC.) TO (TOTAL)STRAIGHT TRUCK FROMTRACTOR AND SEMI-TRAILER PAGE 3 15F (Rev. 5/02) 691TRACTOR – TWO TRAILERSMOTORCOACH – SCHOOL BUSOTHERLIST STATES OPERATED IN FOR LAST FIVE YEARSLIST STATES OPERATED IN FOR LAST FIVE YEARSSHOW SPECIAL COURSES OR TRAINING THAT WILL HELP YOU AS A DRIVERWHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?

EXPERIENCE AND QUALIFICATIONS – OTHERSHOW ANY TRUCKING, TRANSPORTATION OR OTHER EXPERIENCE THAT MAY HELP IN YOUR WORK FOR THIS COMPANYLIST COURSES, TRAINING or CERTIFICATIONS THAT YOU MAY HAVE OTHER THAN SHOWN ELSEWHERE IN THIS APPLICATIONLIST SPECIAL EQUIPMENT OR TECHNICAL MATERIALS YOU CAN WORK WITH (OTHER THAN THOSE ALREADY SHOWN) TO BE READ AND SIGNED BY APPLICANTThis certifies that this application was completed by me, and that all entries on it and information in it are true andcomplete to the best of my knowledge.I authorize you to make such investigations and inquiries of my personal, employment, financial or medical historyand other related matters as may be necessary in arriving at an employment decision. (Generally, inquiriesregarding medical history will be made only if and after a conditional offer of employment has been extended.) Ihereby release employers, schools, health care providers and other persons from all liability in responding toinquiries and releasing information in connection with my application.In the event of employment, I understand that false or misleading information given in my application or interview(s)may result in discharge. I understand, also, that I am required to abide by all rules and regulations of theCompany.___________________________________ ___________________________________________ DATE APPLICANTS SIGNATURE APPLICANT HIRED PROCESS RECORD REJECTEDDATE EMPLOYED POINT EMPLOYEDDEPARTMENT CLASSIFICATION(IF REJECTED, SUMMARY REPORT OF REASONS SHOULD BE PLACED IN FILE) THIS SECTION TO BE FILLED IN BY RESPONSIBLE OFFICER OR COMPANY REPRESENTATIVE SUPERIOR GOOD FAIR BELOW AVERAGE POOR WRITTEN RECORD ON FILE 1.APPLICATION 2.INTERVIEW 3.PAST EMPLOYMENT 4.WRITTEN EXAM 5.ROAD TEST 6.CRIMINAL AND TRAFFIC CONVICTIONS SIGNATURE OF INTERVIEWING OFFICER ________________________________________________________________ TRANSFERSFROM: TO: FROM: TO:DATE: DATE:REASON FOR TRANSFER: REASON FOR TRANSFER:FROM: TO: FROM: TO:DATE: DATE:REASON FOR TRANSFER: REASON FOR TRANSFER:DATE TERMINATED TERMINATION OF EMPLOYMENT OTHERDISMISSEDTERMINATION REPORT PLACED IN FILE DEPARTMENT RELEASED FROM VOLUNTARILY QUITPAGE 4 15F (Rev. 5/02) 691 SUPERVISOR

Department of Homeland Security OMB No. 1615-0047; Expires 08/31/12U.S. Citizenship and Immigration Services Form I-9, Employment Eligibility VerificationRead instructions carefully before completing this form. The instructions must be available during completion of this form.ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOTspecify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have afuture expiration date may also constitute illegal discrimination.Section 1. Employee Information and Verification (To be completed and signed by employee at the time employment begins.)Print Name: Last First Middle Initial Maiden NameAddress (Street Name and Number) State Apt. # Date of Birth (month/day/year)City Zip Code Social Security #I am aware that federal law provides for I attest, under penalty of perjury, that I am (check one of the following):imprisonment and/or fines for false statements or A citizen of the United Statesuse of false documents in connection with the A noncitizen national of the United States (see instructions)completion of this form. A lawful permanent resident (Alien #) An alien authorized to work (Alien # or Admission #)Employee's Signature until (expiration date, if applicable - month/day/year) Date (month/day/year)Preparer and/or Translator Certification (To be completed and signed if Section 1 is prepared by a person other than the employee.) I attest, underpenalty of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the information is true and correct.Preparer's/Translator's Signature Print NameAddress (Street Name and Number, City, State, Zip Code) Date (month/day/year)Section 2. Employer Review and Verification (To be completed and signed by employer. Examine one document from List A ORexamine one document from List B and one from List C, as listed on the reverse of this form, and record the title, number, andexpiration date, if any, of the document(s).) List A OR List B AND List CDocument title:Issuing authority:Document #: Expiration Date (if any):Document #:Expiration Date (if any):CERTIFICATION: I attest, under penalty of perjury, that I have examined the document(s) presented by the above-named employee, thatthe above-listed document(s) appear to be genuine and to relate to the employee named, that the employee began employment on(month/day/year) and that to the best of my knowledge the employee is authorized to work in the United States. (Stateemployment agencies may omit the date the employee began employment.)Signature of Employer or Authorized Representative Print Name TitleBusiness or Organization Name and Address (Street Name and Number, City, State, Zip Code) Date (month/day/year)Section 3. Updating and Reverification (To be completed and signed by employer.)A. New Name (if applicable) B. Date of Rehire (month/day/year) (if applicable)C. If employee's previous grant of work authorization has expired, provide the information below for the document that establishes current employment authorization.Document Title: Document #: Expiration Date (if any):l attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presenteddocument(s), the document(s) l have examined appear to be genuine and to relate to the individual.Signature of Employer or Authorized Representative Date (month/day/year) Form I-9 (Rev. 08/07/09) Y Page 4

LISTS OF ACCEPTABLE DOCUMENTS All documents must be unexpired LIST A LIST B LIST CDocuments that Establish Both Documents that Establish Documents that Establish Identity Employment AuthorizationIdentity and Employment Authorization OR AND1. U.S. Passport or U.S. Passport Card 1. Driver's license or ID card issued by 1. Social Security Account Number a State or outlying possession of the card other than one that specifies2. Permanent Resident Card or Alien United States provided it contains a on the face that the issuance of the Registration Receipt Card (Form photograph or information such as card does not authorize I-551) name, date of birth, gender, height, employment in the United States eye color, and address 2. Certification of Birth Abroad3. Foreign passport that contains a 2. ID card issued by federal, state or issued by the Department of State temporary I-551 stamp or temporary local government agencies or (Form FS-545) I-551 printed notation on a machine- entities, provided it contains a readable immigrant visa photograph or information such as 3. Certification of Report of Birth name, date of birth, gender, height, issued by the Department of State eye color, and address (Form DS-1350)4. Employment Authorization Document 3. School ID card with a photograph 4. Original or certified copy of birththat contains a photograph (Form certificate issued by a State, county, municipal authority, orI-766) 4. Voter's registration card territory of the United States bearing an official seal5. In the case of a nonimmigrant alien 5. U.S. Military card or draft record authorized to work for a specific 5. Native American tribal document employer incident to status, a foreign 6. Military dependent's ID card passport with Form I-94 or Form 6. U.S. Citizen ID Card (Form I-197) I-94A bearing the same name as the 7. U.S. Coast Guard Merchant Mariner passport and containing an Card 7. Identification Card for Use of endorsement of the alien's Resident Citizen in the United nonimmigrant status, as long as the 8. Native American tribal document States (Form I-179) period of endorsement has not yet expired and the proposed 9. Driver's license issued by a Canadian 8. Employment authorization employment is not in conflict with government authority document issued by the any restrictions or limitations Department of Homeland Security identified on the form For persons under age 18 who are unable to present a6. Passport from the Federated States of document listed above: Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with 10. School record or report card Form I-94 or Form I-94A indicating nonimmigrant admission under the 11. Clinic, doctor, or hospital record Compact of Free Association Between the United States and the 12. Day-care or nursery school record FSM or RMIIllustrations of many of these documents appear in Part 8 of the Handbook for Employers (M-274) Form I-9 (Rev. 08/07/09) Y Page 5

Contract DriverNAIT Association Program Insurance ApplicationApplicant Name: Mr. Mrs. Ms. First Middle LastAddress: City State Zip Street/PO Box Apt Phone: Date of Birth:Social Security #: What do you haul? CDL State:CDL #:Fleet Owner Name & Address: __________________________________________________________________________ __________________________________________________________________________________________________Insurance services provided by TransGuard General Agency, Inc. (“TGA”); In California, doing business as TransGuardGeneral Insurance Agency; In Utah, doing business as TransGuard General Insurance Agency, Inc. If you need coveragethat is not addressed in this application, please contact TransGuard General Agency, Inc. at (800) 821-8014 for assistance.OCCUPATIONAL ACCIDENTDo you want to purchase Occupational Accident coverage for yourself? Yes* No*If yes, please complete the following information:How is your income reported: 1099 W-2 Height:_____Feet _____Inches Weight:______Please name a beneficiary for the payment of accidental death benefits. (Accidental death benefits are payable toyour surviving spouse or dependent children, subject to the terms and conditions of this coverage. The beneficiarydesignation requested only applies when benefits are payable and you do not have a spouse or dependent childrensurviving.)Name of Beneficiary Address (Street/City/State/Zip) RelationshipHave you been injured in a work-related accident during the past 36 months? Yes NoDate of Accident/Injury: _________________________________________________________________________Explanation of Accident/Injury: _______________________________________________________________________________________________________________________________________________________________Treatment Received: __________________________________________________________________________Have you received medical treatment for a health-related condition in the past 36 months? Yes NoDescribe health related condition and treatment received: __________________________________________________________________________________________________________________________________________Are you presently taking any prescription medications? Yes NoList medications and what conditions they are used to treat: ________________________________________________________________________________________________________________________________________Do you have any health restrictions or limitations on the type of work you can perform? Yes NoDescribe restrictions and limitations: ___________________________________________________________________________________________________________________________________________________________Do you have a disability rating? Yes* No*If yes, give percentage: %_________ Disabled area:_____________________________________________________ What caused the disability? _____________________________________________________________________When this coverage is provided, you will be insured under the Occupational Accident plan elected by your fleetowner’s motor carrier as satisfying their coverage requirements or the plan you elect if billed direct pay. You arealso selecting Non-Occupational Accident Coverage with this purchase if your fleet owner’s motor carrier requiressuch coverage on the date of application. If Occupational Accident Coverage for a Helper / Co-driver or Partner isneeded, a separate supplemental application must be completed. Contact TransGuard General Agency, Inc. forassistance.018050 07/15 Mail to: TransGuard/NAIT Association Program, PO Box 901606, Kansas City, MO 64190-1555 1 of 4 Or, Fax to (816) 713-1333 www.transguard.com Phone: (800) 821-8014

WORKERS’ COMPENSATION (Excludes sole-proprietor and partner, this coverage is for your casuals/helpers only)Do you want to purchase coverage for your casuals/helpers? Yes NoYour FEIN / State Tax ID #: _________________________COMMERCIAL BUSINESS AUTODo you want to purchase Physical Damage Coverage? Yes No $1000 $2500 Which Comprehensive/Collision Deductible? $250 $500Stated Amount: $_____________Tractor Trailer Other: ________________________________________________________________________________ _________________________________________ _____________________________________Year Manufacturer/Model/Gross Weight VIN#__________________________ ___________________________________________________________________Loss Payee (lien holder/lessor) Loss Payee AddressNAIT MEMBERSHIPI understand that I must be a member of the National Association of Independent Truckers (“NAIT”) in order to participate inits insurance programs. If I am not currently a member, I will apply for membership. I may become and remain a member ofNAIT without the purchase of NAIT sponsored insurance.POLICY TERMS AND CONDITIONSCoverage applied for under the NAIT insurance program is subject to all the terms, conditions and limitations of the policyproviding the coverage requested.PAYMENT TERMS: I understand that the cost of this insurance is my sole obligation and responsibility, and I agreethat I will pay upon demand or at any time my account remains unpaid, any amount due and owing. I also understand that ifmy insurance is canceled my deposit premium will be used to cover my outstanding premium. If the motor carrier to whommy fleet owner is under contract has agreed to settlement deduction arrangements for the payment of premium, I herebyAPPOINT that motor carrier as my agent for receipt of NAIT Program billing notices and AUTHORIZE them to makedeductions from my account equal to the cost of NAIT membership dues, benefits and insurance premiums and to remitsame as required on my behalf. I also authorize the motor carrier named on page 4 of this application or on my Evidence ofCoverage, if changed, to remit any deposit premium and/ or membership dues required for participation in NAIT’s insuranceprograms. Deposit premium is fully refundable upon termination of coverage if my account is current and in good standing. Iunderstand there is a one-month deposit charge for NAIT membership dues and a one month deposit premium charge for allinsurance coverages, except Workers’ Compensation. For Workers’ Compensation, a state mandated minimum charge, perpolicy, is applicable.AGREEMENTSI certify that I am DOT qualified and that I have complied with all applicable DOT requirements. I am not now, nor will Ibecome, an employee of any motor carrier or fleet owner while any insurance provided through an NAIT program is in force.I authorize the release to TGA, its affiliated insurers and their representatives, if necessary: 1) all insurance documentsrelated to me and/or my insured equipment; 2) my current Motor Vehicle Report (MVR), including updates as needed; 3)applicable medical records; 4) any test results in accordance with DOT regulations; 5) a copy of my current equipment leaseagreement(s), if any; and 6) a copy of my independent contractor agreement with my fleet owner. I understand thisinformation may be used for purposes of evaluating my application for insurance. I authorize the motor carrier listed on myEvidence of Coverage to request cancellation of my coverage whose premium is paid by settlement deduction arrangementswhen I am no longer under contract to my fleet owner or when my fleet owner is no longer under contract to that motorcarrier. I understand NAIT, as group policyholder, has authority to execute and cancel all group coverage. I knowingly rejectstatutory Workers’ Compensation coverage when opting for Occupational Accident coverage, if required by state law.018050 07/15 Mail to: TransGuard/NAIT Association Program, PO Box 901606, Kansas City, MO 64190-1555 2 of 4 Or, Fax to (816) 713-1333 www.transguard.com Phone: (800) 821-8014

AGREEMENTS (CONTINUED)Applicable To Occupational Accident coverage only: I further understand and agree that as an independent contractorand in choosing this Occupational Accident coverage, I am not able to file nor otherwise assert any claim for statutoryWorkers’ Compensation benefits against my fleet owner, my fleet owner’s motor carrier and/or any insurers or othercompanies related to such entities. I further agree to indemnify and forever hold harmless NAIT, my fleet owner, my fleetowner’s motor carrier and/or any insurers or other companies related to any of the foregoing entities of and from any and allclaims that may be made by me or by anyone else on my behalf for statutory Workers’ Compensation benefits.A credit report or other investigative report about me may be requested in connection with this application for insurance andsubsequent renewals. Any information about me or which I have provided about anyone will be treated confidentially.However, this information, as well as other non-public personal or privileged information subsequently collected, may, undercertain circumstances, be disclosed without prior authorization to non-affiliated third parties. Information may be shared withaffiliated companies for such purposes as claims handling, servicing, underwriting and insurance marketing. I have the rightto see personal information collected about me, and I have the right to correct any information which may be wrong. Adescription of TGA’s information practices, and my rights regarding information TGA collects may be obtained by contactingTGA.I certify the information that I have provided in this application is true, complete and accurately recorded to the best of myknowledge and belief. I understand this information will be used to apply for insurance coverage on my behalf. If approved,this application will be attached to and made a part of each policy providing the coverage requested. I certify that I havefulfilled all requirements to work legally in the U.S. by 1) being a U.S. citizen and/or 2) being in full compliance with all Federallaws and/or regulations regarding work eligibility. I understand that the giving of any inaccurate, false, or misleadinginformation on this application may result in rejection of this application and the denial of benefits under any and allinsurance coverage for which I have applied.FRAUD WARNINGSFraud Warning applicable to residents of all states except those listed below and Nebraska: Any person who knowingly and withintent to defraud any insurance company or other person files an application for insurance or a statement of claim containing any materiallyfalse information, or conceals, for the purpose of misleading, information concerning any fact material thereto, commits a fraudulentinsurance act, which is a crime and subjects such person to criminal and civil penalties.ADDITIONAL STATE SPECIFIC FRAUD LANGUAGEIN ARKANSAS, LOUISIANA AND MARYLAND - Any person who knowingly presents a false or fraudulent claim for payment of a loss orbenefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines andconfinement in prison.IN CALIFORNIA - For your protection California law requires the following to appear on this form: Any person who knowingly presents afalse or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.IN COLORADO - It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for thepurpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civildamages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts orinformation to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard toa settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department ofRegulatory Agencies.IN DISTRICT OF COLUMBIA – Warning: It is a crime to provide false or misleading information to an insurer for the purpose ofdefrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurancebenefits if false information materially related to a claim was provided by the applicant.IN FLORIDA - Any person who knowingly and with intent in injure, defraud, or deceive any insurer files a statement of claim or anapplication containing any false, incomplete, or misleading information is guilty of a felony of the third degree.IN HAWAII - For your protection, Hawaii law requires you to be informed that any person who presents a fraudulent claim for payment ofa loss or benefit is guilty of a crime punishable by fines or imprisonment, or both.IN KENTUCKY – Any person who knowingly and with intent to defraud any insurance company or other person files an application forinsurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact materialthereto commits a fraudulent insurance act, which is a crime.IN MAINE - It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose ofdefrauding the company. Penalties may include imprisonment, fines or denial of insurance benefits.INITIAL/DATE:________________018050 07/15 Mail to: TransGuard/NAIT Association Program, PO Box 901606, Kansas City, MO 64190-1555 3 of 4 Or, Fax to (816) 713-1333 www.transguard.com Phone: (800) 821-8014

ADDITIONAL STATE SPECIFIC FRAUD LANGUAGE (CONTINUED)IN NEW JERSEY - Any person who includes any false or misleading information on an application for an insurance policy is subject tocriminal and civil penaltiesIN NEW MEXICO - Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presentsfalse information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.IN NEW YORK - Any person who knowingly and with intent to defraud any insurance company or other person files an application forinsurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, informationconcerning any fact material thereto, and any person who knowingly makes or knowingly assists, abets, solicits or conspires with anotherto make a false report of the theft, destruction, damage or conversion of any motor vehicle to a law enforcement agency, the departmentof motor vehicles or an insurance company, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civilpenalty not to exceed $5,000 and the value of the subject motor vehicle or stated claim for each violation.IN OHIO - Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application orfiles a claim containing a false or deceptive statement is guilty of insurance fraud.IN OKLAHOMA - Warning – Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim forthe proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.IN OREGON - Any person who knowingly and with intent to defraud any insurance company or another person files an application forinsurance or statement of claim containing any materially false information may be subject to prosecution for insurance fraud.IN PENNSYLVANIA – Any person who knowingly and with intent to injure or defraud any insurer files an application or claim containingany false, incomplete or misleading information shall, upon conviction, be subject to imprisonment for up to seven years and payment ofa fine of up to $15,000.IN TENNESSEE, VIRGINIA AND WASHINGTON - It is a crime to knowingly provide false, incomplete or misleading information to aninsurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.I UNDERSTAND AND AGREE THAT COVERAGE REQUESTED IN THIS APPLICATION WILL NOT BE AFFORDEDUNTIL THIS APPLICATION IS SUBMITTED AND I AM APPROVED. I CERTIFY AND REPRESENT THAT I HAVE READAND UNDERSTAND THIS APPLICATION USING TRANSLATION SERVICES AS NEEDED AND THAT THEINFORMATION I HAVE PROVIDED AND THE REPRESENTATIONS I HAVE MADE HEREIN ARE TRUE AND CORRECT.I certify that I am an independent contractor and not an employee of my fleet owner or my fleet owner’s motor carrier.APPLICANT SIGNATURE DATEMOTOR CARRIER NAME/TERMINAL LOCATION UNIT NUMBERI certify that I am an independent contractor and not an employee of any motor carrier and that the applicant is not myemployee but is an independent contractor working on my behalf.FLEET OWNER SIGNATURE ____________________________________ DATE018050 07/15 Mail to: TransGuard/NAIT Association Program, PO Box 901606, Kansas City, MO 64190-1555 4 of 4 Or, Fax to (816) 713-1333 www.transguard.com Phone: (800) 821-8014

Direct Deposit Authorization FormPlease print and complete ALL the information below.Name: ____________________________________________________________Address: ____________________________________________________________City, State, Zip: ____________________________________________________________ !Name of Bank: ____________________________________________________________Account #: ____________________________________________________________9-Digit Routing #: ____________________________________________________________Amount: $ ______________ _______% or Entire PaycheckType of Account: Checking SavingsPlease attach a voided check for each bank account to which funds should be deposited.__________________________ is hereby authorized to directly deposit my pay to the accountlisted above. This authorization will remain in effect until I modify or cancel it in writing.Employee Signature: ___________________________ Date: ______________________

INDEPENDENT CONTRACTOR AGREEMENT FOR OWNER-OPERATORTHIS AGREEMENT is made this in the State of ILLINOIS by and between R2R Intermodal Inc. a regulated for hire motor carrier, an IL corporation and (\"CONTRACTOR\"), as follows:WHEREAS, R2R Intermodal Inc is engaged in business to provide trucking service for different customers andintends to contract with CONTRACTOR in the performance of certain tasks; WHEREAS, between R2R Intermodal Inc. principal place of business is located at the following address: 2636West Foster Ave Chicago, IL 60625WHEREAS, CONTRACTORS principal place of business is located at the following address:__________________________________________________________________________________________________________________________________________________________________________________________WHEREAS, CONTRACTOR is doing business at a (check one):Partnership Sole Proprietorship Corporation NOW THEREFORE, in consideration of the mutual covenants herein contained the sufficiency of which isacknowledged, it is agreed as follows:1. Effective Date This agreement shall become effective upon signing by both parties and shall remain in effect for one (1) year from date of signing, and shall automatically renew for additional like periods, not to exceed a total of three (3) years unless: sooner canceled.2. Termination This Agreement may be terminated: A. Without cause, upon either party giving the other thirty (30) days prior written notice; or B. For cause, immediately, upon material breach of any term of this Agreement by either of the parties. C. CONTRACTOR has the right to terminate this Agreement under the terms stated herein. In accordance with Section 212.1 (a) (2) of the Illinois Unemployment Insurance Act, following termination, CONTRACTOR has the right to perform the same or similar services, on whatever basis and whenever CONTRACTOR chooses, for persons or entities other than R2R Intermodal Inc. except as limited by the requirements promulgated by regulations of the Federal Highway Administration Illinois commerce Commission, or any other regulatory body having jurisdiction.3. Registration/Licensing of R2R Intermodal Inc. A. Such as contemplated by Section 212.1 (a)(1) of the Illinois Unemployment Insurance Act R2R Intermodal Inc. is a for hire motor carrier authorized to transport property pursuant to licenses issued by Page 1 of 10

the Federal Highway Administration (successor in interest to the Interstate Commerce Commission) and other federal and state operating authorities and licenses. B. R2R Intermodal Inc. will use said Equipment in its business as a motor carrier, under its various certificates or permits which it now holds or which it may subsequently acquire, where such are required. Such Equipment furnished to R2R Intermodal Inc. shall be exclusively used in R2R Intermodal Inc. business to the extent required by all applicable laws and regulations. Said Equipment shall, during the term of this Agreement, be under R2R Intermodal Inc. exclusive possession, use and control, to the extent contemplated by and required by all applicable federal and state laws and regulations relating to the operation of leased motor vehicle equipment by motor carriers R2R Intermodal Inc. assumes full responsibility for the operation of said Equipment as to all third parties and the public at large. However, this shall no way modify, alter or affect CONTRACTOR’S status as an Independent Contractor, and not an employee of R2R Intermodal Inc. Nothing in this Agreement shall be deemed as a delegation of R2R Intermodal Inc. duties as a common or contract or contract carrier to CONTRACTOR in so far as the public or any governmental or regulatory body may be concerned. The terms of this Agreement are merely an assignment and distribution of various costs arising out of the operations to be conducted pursuant to this Agreement, between the parties to this Agreement.4. Ownership of Equipment In accordance with Section 212.1(a) (4) of the Illinois Unemployment Insurance Act. CONTRACTORdeclares that it holds title to (or is otherwise legally entitled to lease) said Equipment and does lease to R2RIntermodal Inc. The Equipment described in Appendix “A,” attached to this Agreement and made a part hereof.That equipment is referred to in this Agreement as “Equipment.”5. Name and Address on CONTRACTOR’S EQUIPMENT In accordance with Section 212.1 (a) (6) of the Illinois Unemployment Insurance Act, CONTRACTORagrees to display its business name and address on all Equipment covered by this Agreement. Any such displayof business name and address shall comply with applicable law and with the rules and regulations of the UnitedStates Department of Transportation.6. Availability and Scheduling In accordance with Section 212.1 (a) (3) of the Illinois Unemployment Insurance Act, CONTRACTOR isnot required by R2R Intermodal Inc. to perform service or be available to perform services at specific times oraccording to a schedule or for a number of hours specified by R2R Intermodal Inc. However, pickup or deliverytimes specified by a shipper, receiver, broker, or other party that owns or controls a shipment shall not be deemed“specified” by.7. Licensing and Operating Costs A. CONTRACTOR’s Costs, In accordance with Section 212.1 (a) (5) of the Illinois Unemployment Insurance Act, CONTRACTOR shall pay all costs of licensing and operating the Equipment (except when federal or state law or regulation requires R2R Intermodal Inc to pay), and no costs of such licensing or operating shall be separately reimbursed by any other person or entity. Also, CONTRACTOR agrees to pay a reasonable rental, to be negotiated between the parties, If CONTRACTOR desires to rent trailer(s). CONTRACTOR agrees that the Equipment described herein will be kept and maintained in first-class condition and repair at CONTRACTOR’S sole expense. Page 2 of 10

CONTRACTOR agrees to pay all of the expenses incurred in operating the Equipment which is the subject of this Agreement, without limitation, including, but not limited to, those items enumerated in 49 C.F.R. §376.12(e) cost of fuel, fuel taxes, empty miles, permits of all types, tolls, ferries, detention, accessorial services, base plates and licenses, and the unused portion of such items]. Upon failure of CONTRACTOR to make such payments, R2R Intermodal Inc. may avail itself of any remedies described in Paragraph (2) herein or elsewhere in this Agreement.B. SAFETY COMPLIANCE, CONTRACTOR warrants that the Equipment leased herein complies with all of the required safety rules and complies with all rules and regulations of the United States Department of Transportation, and any and all federal, state or local regulatory bodies having jurisdiction over the operation of said Equipment, and that all taxes, of any nature, assessable against the leased Equipment or its operation have been paid. All costs incurred in connection with causing the Equipment leased hereunder to comply with said rules and regulations and any loss, damage or expense of any nature, whatsoever, which shall result from CONTRACTOR’S failure to ensure such compliance, shall be borne by CONTRACTOR. Upon failure of CONTRACTOR to promptly and immediately ensure such compliance and pay such costs or expenses R2R Intermodal Inc. pay, at its exclusive option, effect such compliance, pay such costs or expenses, and deduct the amount of such payment, together with any administrative expenses incurred in so doing, from any monies due of which may become due to CONTRACTOR pursuant to this Agreement. Before making any such deduction, R2R Intermodal Inc. shall give CONTRACTOR an itemized statement, setting forth the amount and allocation of any such deductions.C. LICENSE PLATES, CONTRACTOR shall purchase and pay for all license plates necessary for the operation of the equipment leased herein, in CONTRACTOR’S name, and said license plates shall remain the sole property of CONTRACTOR.D. CHARGES, Neither CONTRACTOR nor any personnel furnished by CONTRACTOR shall charge any purchases, of any nature. To R2R Intermodal Inc., should CONTRACTOR or its personnel, in violation of this Paragraph, charge any purchases to R2R Intermodal Inc. R2R Intermodal Inc. shall have the right to set off and deduct the amount of any such charges, together with any administrative expenses incurred, from any monies due or which may become due to CONTRACTOR pursuant to this Agreement and to avail itself of any other remedies described elsewhere in this Agreement. Before so doing, shall give CONTRACTOR a written statement of all such charges and set-offs.E. ADVANCES, In the event that R2R Intermodal Inc. shall be required to make any advances or payments for and/or on behalf of CONTRATOR’S obligation for necessary operating expenses or repairs on said Equipment, then R2R Intermodal Inc. shall have the right to withhold an equivalent sum, plus any administrative expenses incurred by R2R Intermodal Inc., in making such advances, as a set- off, from funds due CONTRACTOR as rental payment hereunder, or from any other sums which R2R Intermodal Inc. may owe to CONTRACTOR, to secure the repayment of any such advances or payments. R2R Intermodal Inc. will first give CONTRACTOR an itemized written statement for, or explanation of, all deductions made. CONTRACTOR hereby authorizes irrevocably any agent of any court of record to appear for CONTRACTOR in such court and confess judgment, without process, on favor of R2R Intermodal Inc. for such amounts of any advance or payments which R2R Intermodal Inc. has made on behalf of CONTRACTOR which remains unpaid, together with reasonable costs of collection, including attorneys’ fees, and to waive and release all errors which may intervene in any such judgment, hereby ratifying and confirming all that said attorney may do by virtue hereof. Page 3 of 10

F. R2R Intermodal Inc. NOT LIABLE, R2R Intermodal Inc. shall not, in any way, be liable for fire, theft, loss or damage to the Equipment leased hereunder, no matter how arising. G. INSURANCE, it is recognized that the United States Department of Transportation and various other regulatory bodies require the carrier under whose certificates or permits leased Equipment is being operated to be responsible to the public with respect to such Equipment while some is being operated under its authority. R2R Intermodal Inc. will file, or has on file, with the United States Department of Transportation and any other regulatory body having jurisdiction over its operations, evidence of insurance in such amounts as may be required by law or regulation of said agencies, and will continuously maintain in effect insurance in such amount. CONTRACTOR shall secure, at its sole expense, insurance in the minimum amount of $1,000,000 combined single limits covering bob-tail and dead-heading on the Equipment leased herein and shall furnish R2R Intermodal Inc. with a certificate naming R2R Intermodal Inc as an additional insured thereunder. In addition, CONTRACTOR will carry at its sole expense, its own insurance coverage on the Equipment leased for collision, fire, theft and other occurrence or catastrophe, and R2R Intermodal Inc. shall be named as an insured thereunder also. R2R Intermodal Inc. shall furnish and may charge back to CONTRACTOR all costs of public liability, property damage, cargo and comprehensive insurance on the Equipment which is the subject of this Agreement, while it is operated in the service of R2R Intermodal Inc. The actual amount to be charged to CONTRACTOR for said insurance coverages shall be as act forth in APPENDIX “B” of this Agreement. Further R2R Intermodal Inc. shall furnish CONTRACTOR with copies of and the policy numbers of all such insurance policies, as well as certificates of insurance therefore containing all of the information required by 49 C.F.R. §376.12(j) (2). CONTRACTOR’S responsibility to indemnify R2R Intermodal Inc. for claims or losses, as set forth in this Agreement, is limited to the extent that such claims or losses, or any portion thereof, are not covered by such insurance policies.8. Insurance/Benefits/Warranties A. INSURANCE COVERAGES, CONTRACTOR will carry, at the own expense, the following insurance coverages with the described minimum limits: 1) Commercial General Liability Coverage. Commercial general liability coverage with $1,000,000 per occurrence limits. 2) Commercial Automobile Coverage. Commercial automobile coverage with minimum limits of $1,000,000 combined single limit and $1,000,000 uninsured/underinsured coverage. CONTRACTOR must prove that its coverage is primary and acceptable to R2R Intermodal Inc. To determine this, CONTRACTOR will provide R2R Intermodal Inc. with a duplicate copy of its commercial auto policy. R2R Intermodal Inc will notify CONTRACTOR within thirty (30) days of acceptance if coverage or certificate is not acceptable. 3) Workers’ Compensation Coverage or Occupational Accident Insurance. CONTRACTOR shall maintain workers’ compensation coverage for CONTRACTOR, its agents, servants and employees. B. CERTIFICATE OF INSURANCE. CONTRACTOR will furnish R2R Intermodal Inc an insurance certificate for all required coverages shown above naming R2R Intermodal Inc. as an “Additional Insured” on the general liability and commercial auto liability coverages. Contractor or its insurance Page 4 of 10

carrier(s) shall give R2R Intermodal Inc not less than thirty (30) days prior notice of any cancellation of any insurance policy or coverage(s) or such cancellation shall not be effective as to R2R Intermodal Inc.C. NO BENEFITS. CONTRACTOR further understands and agrees that CONTRACTOR and CONTRACTOR’S subcontractor, agents or employees are not entitled to any employee benefits normally granted to R2R Intermodal Inc’s employees, and CONTRACTOR shall indemnify and hold R2R Intermodal Inc. forever harmless from any and all liabilities (including expense and attorneys’ fees) and all costs, loss, expenses or damages are arising from employee compensation or benefits, unemployment, Social Security or any other tax deduction or any employee benefits including, but not limited to, group accident and health insurance or any workers’ compensation claims, injuries to or omissions of CONTRACTOR or CONTRACTOR’S subcontractors, agents or employees for failure to comply with the terms and obligations of this Agreement.D. CONTRACTOR NOT COVERED. It is expressly understood and agreed that, because of CONTRACTOR’S independent contractor status, R2R Intermodal Inc. is not obligated to carry any insurance covering CONTRACTOR, including workers’ compensation insurance, and that CONTRACTOR shall be responsible for the payment of premiums on any health, liability, or accident insurance carried by CONTRACTOR for its protection, or the protection of its subcontractors, agents and employees.E. DRIVERS QUALIFIED. CONTRACTOR warrants that CONTRACTOR will furnish to operate all Equipment leased pursuant to this Agreement only drivers or personnel who are qualified and competent. CONTRACTOR agrees that all drivers and personnel furnished will be required to meet all of the rules and regulations o the United States Department of Transportation, and any other regulatory body having jurisdiction as to safety, hours of service, inspection and maintenance, the taking of physical examinations, and furnishing a certificate therefore. All drivers and personnel will be required to comply as to the qualifications, training program, drug and alcohol testing and safety rules of the United States Department of Transportation, and any other body having jurisdiction. It is further agreed that all drivers and personnel furnished by CONTRACTOR shall comply with all rules and regulations prescribed by any regulatory body having jurisdiction over the operations to be conducted pursuant to this Agreement. CONTRACTOR will ensure that all records pertaining to the foregoing will be furnished to R2R Intermodal Inc. In order that R2R Intermodal Inc. can keep and maintain such records in accordance with the rules and regulations of all regulatory bodies having jurisdiction over these operations.F. FINES AND PENALTIES. R2R Intemrodal Inc shall not be responsible for any fine, expenses or costs incurred by CONTRACTOR or any drivers or personnel furnished by CONTRACTOR, by reason of its or their violation of, or failure to adhere to, any federal or state law, local ordinance or regulation, or rule or regulation of any federal, state or local regulatory body having jurisdiction; provided, however, that R2R Intermodal Inc. agrees to pay all fines and penalties inadequacies in operating authorities or license where it is mandatory that such be issued in R2R Intermodal Inc. R2R Intermodal Inc. shall be responsible for fines for overweight or over-dimension trailers when trailers are pre-loaded sealed or the load is containerized, or when the trailer or lading is otherwise outside of CONTRACTOR’S control, except when such fine shall be the result of an act or mission of CONTRACTOR or personnel furnished by CONTRACTOR.G. CONTRACTOR’S PERSONNEL. As between R2R Intermodal Inc. and CONTRACTOR, except as may be otherwise required by law or regulation, CONTRACTOR shall be solely responsible for the direction and supervision of all personnel furnished by CONTRACTOR in connection with this Page 5 of 10

Agreement, including, but not limited to, the selection, hiring, firing, supervising, directing, training, setting wages, hours and working conditions, paying and adjusting grievances. As between CONTRACTOR and R2R Intermodal Inc. only, CONTRACTOR shall be solely and exclusively responsible for all aspects of the operation of the Equipment leased hereunder.9. Compensation A. The compensation and additional terms affecting payment of that compensation are stated in APPENDIX “B,” attached to this Agreement and made a part hereof. B. In order that CONTRACTOR may verify the accuracy of all payments made pursuant to this Agreement, where payment is predicated upon a percentage of gross revenues, R2R Intermodal Inc. shall present CONTRACTOR with copies of rated freight bills, or a computer-generated document containing all of the same information, for all shipments transported in or with equipment leased pursuant to this Agreement. CONTRACTOR shall have the right to examine copies of R2R Intermodal Inc. tariffs or rate schedules at R2R Intermodal Inc. home office during reasonable business hours. In those circumstances when CONTRACTOR is given a computer-generated document rather than a copy of a freight bill, CONTRACTOR shall have the right to examine the source document(s) from which such computer-generated information was compiled, under the same conditions. However, R2R Intermodal Inc. shall have the right to block out or obliterate all references on such freight bills, source document(s), tariffs and rate schedules as to the identity of customers, shippers and consignees.10. CONTRACTOR’s General Duties A. INSPECTION/WARRANTY. R2R Intermodal Inc. shall, prior to taking possession of the Equipment, Inspect said equipment. CONTRACTOR warrants that the Equipment is complete with all required accessories, appurtenances and appliances, and that the same is in good, safe and efficient operating condition and shall be so maintained, at CONTRACTOR’S sole expense throughout the duration of this Agreement. CONTRACTOR shall and will submit said Equipment for R2R Intermodal Inc. Inspection at the time R2R Intermodal Inc. takes possession and periodically thereafter, as required by R2R Intermodal Inc. CONTRACTOR shall furnish R2R Intermodal Inc. with all necessary information and documents of title or registration so as to enable R2R Intermodal Inc. to correctly identify and license the Equipment. CONTRACTOR shall furnish R2R Intermodal Inc copies of all statements or invoices for repairs to said Equipment on a monthly basis, whether than by CONTRACTOR or by a third party. R2R intermodal Inc. reserves the right to inspect the Equipment at any time, and if R2R Intermodal Inc exercises this right and the Equipment shall be utilized in R2R Intermodal Inc. service, as R2R Intermodal Inc. sees fit, CONTRACTOR shall not hinder or deter R2R Intermodal Inc’s utilization in any manner whatsoever, Nothing in this Paragraph or Agreement shall obligate R2R Intermodal Inc. utilize said Equipment with any specific frequency, for any specific number or miles, trips or pounds of freight. B. RECEIPTS FOR EQUIPMENT. When possession of said Equipment is taken by R2R Intermodal Inc. under the terms of this Agreement, R2R Intermodal Inc. shall issue to CONTRACTOR, on the form attached hereto as APPENDIX “C,” a receipt for said Equipment, stating the date and time at which possession is taken. When possession is retaken by CONTRACTOR, CONTRACTOR shall give R2R Intermodal Inc. a similar receipt on the form attached hereto as APPENDIX “C.” This Agreement shall not be considered terminated, for the sole purpose of calculating the time limits for payment of trip settlements due to CONTRACTOR hereunder, until CONTRACTOR has given R2R Intermodal Inc. its receipt, as act forth herein above acknowledging return of the Equipment to CONTRACTOR. Upon Page 6 of 10

termination of this Agreement, R2R Intermodal Inc. shall not be obligated to pay any accrued rentals due to CONTRACTOR in connection with said Equipment, until after CONTRACTOR’S receipt for the Equipment is received by11. Subleasing/Trip Leasing/Etc. A. R2R Intermodal Inc. may sublease the Equipment which is the subject of this Agreement whenever permitted by applicable laws and regulations, and R2R Intermodal Inc. shall be considered to be the owner of said Equipment for the purpose of any such subleasing if such is required by law or regulation. Neither party may assign this Agreement. CONTRACTOR may not act as R2R Intermodal agent for the trip of sublease of the subject Equipment, except upon such express terms and conditions as R2R Intermodal Inc. may establish. In the event that CONTRACTOR trip-leases the subject Equipment without first having obtained R2R Intermodal Inc. approval, then R2R Intermodal Inc shall not be responsible to CONTRACTOR for the payment of any monies relating to said trip lease, unless and until R2R Intermodal Inc. has actually received payment from the trip-lease carrier, nor shall R2R Intermodal Inc. be responsible for any obligations to any trip-lessee undertaken by CONTRACTOR Further, it is the responsibility of CONTRACTOR to submit all paper work relating to a trip-lease shipment to R2R Intermodal Inc. and not to the trip-lease carrier. R2R Intermodal Inc shall then immediately forward said paperwork to the trip-lease carrier. B. Consistent with its independent contractor status, CONTRACTOR is free to, and may, lease or trip to other carriers at such times as the Equipment that is not being utilized by R2R Intermodal Inc, If CONTRACTOR enters into a sublease, CONTRACTOR agrees to assume all responsibility and hold R2R Intermodal Inc harmless from any claim by CONTRACTOR, its subcontractors, agents or employees during such sublease. C. At those times when CONTRACTOR is not operating under R2R Intermodal Inc. operating authorities or otherwise operating in R2R Intermodal Inc. service pursuant to this Agreement, or is hauling for someone else, CONTRACTOR agrees to cover or remove any signs and/or other identification on the Equipment containing R2R Intermodal Inc. name and or motor carrier identification numbers.12. Indemnification by Contractor As between R2R Intermodal Inc. and CONTRACTOR only, without any regard or effect upon theobligation R2R Intermodal Inc. any third party, CONTRACTOR agrees to be responsible for, indemnify andhold R2R Intermodal Inc. harmless from any and all claims of any nature, losses, personal injury, death, and/ordamage to cargo or other property, and/or claim for any such loss or occurrence which may arise from or inconnection with the operations performed or to be performed pursuant to this Agreement, however arising,without regard to fault or negligence on the part of CONTRACTOR. This is to include, but is not limited to,attorneys’ fees and any other expenses incurred in defending or processing any claim arising as a result of any ofthe above or operation of the Equipment leased herein. R2R Intermodal Inc. may deduct any sums for whichCONTRACTOR is responsible hereunder from any monies that R2R Intermodal Inc. may owe toCONTRACTOR as rentals or from any other sums which R2R Intermodal Inc. may owe to CONTRACTORafter first giving CONTRACTOR on itemized statement therefore. Page 7 of 10

13. Miscellaneous ProvisionsA. LABOR DISPUTE. CONTRACTOR hereby agrees that should it become involved in a labor dispute with its employees or with drivers or other personnel furnished to R2R Intermodal Inc. It will immediately report such fact to R2R Intermodal Inc. If such labor dispute interferes or tends to interfere with the operations of CONTRACTOR for R2R Intermodal Inc. pursuant to this Agreement, then this Agreement shall be subject to immediate cancellation by R2R Intermodal Inc. without penalty.B. RENT/PURCHASE. CONTRACTOR is not required to purchase or rent any products, equipment or service from R2R Intermodal Inc. as a condition of this Agreement.C. LOADING/UNLOADING. Loading of freight onto the Equipment, which is the subject of this Agreement, is the responsibility of CONTRACTOR and shall be done at CONTRACTOR’S expense. Unloading of freight is the responsibility of CONTRACTOR and shall be done at CONTRACTOR’S expense.D. R2R Intermodal Inc’s TRAILER. In the event that a vehicle leased from CONTRACTORpursuant to this Agreement shall be utilized pulling trailer or chassis furnished by R2R IntermodalInc. and during the course of any such operation any such trailer should become damaged,regardless of how such damage may occur, by or during said operations, then CONTRACTORshall pay to R2R Intermodal Inc. all such damages to said trailer and all other consequentialdamages which R2R Intermodal Inc. may suffer flowing there from, after first givingCONTRACTOR credit for any sums recovered by R2R Intermodal Inc. by way of insurance orotherwise, with regard to said trailer.E. COMPLETE AGREEMENT. This Agreement shall supersede, replace and take precedence over any prior agreement of a similar character between the parties hereto. This Agreement shall constitute the complete Agreement between the parties, and no agent or employee of either party shall have the authority to alter or vary the terms hereof or to make any representations or commitments not included herein. This Agreement shall not be assignable except with the express written consent of both parties. This Agreement shall be interpreted and governed pursuant to the laws of State IL and any action pertaining thereto shall be brought and maintained exclusively in Courts in the State of IL.F. COPIES. This Agreement shall be executed in at least three (3) copies, each of which shall be considered an original, to the end that one executed copy, known as “R2R Intermodal Inc. Copy” shall be retained by R2R Intermodal Inc. one executed copy known as “CONTRACTOR’S Copy” shall be retained by CONTRACTOR; and one executed copy known as “Equipment Copy” shall be carried in the Equipment during the term of this Agreement and returned to R2R Intermodal Inc. at the conclusion of this Agreement. Additional copies may be signed where necessary, and, when signed, such additional copies shall also be considered as originals and may be filed with appropriate regulatory bodies.14. Independent Contractor Status/Tax Treatment Page 8 of 10

CONTRACTOR acknowledges and agrees that it has been engaged as an independent contractor andnot as an employee. It shall be, therefore, responsible for payment of all federal, state and local taxes arising outof Its activities under this Agreement, and/or the activities of its subcontractors, agents and employees includingby way of Illustration, but not limitation, federal and state income tax, Social Security tax, unemploymentinsurance taxes, where applicable, and business license fees, where required. CONTRACTOR understands andagrees that R2R Intermodal Inc. is not obligated or responsible to deduct any taxes which may be imposed byany governmental authority from the fees as paid to CONTRACTOR or CONTRATOR’S subcontractors, agentsor employees by R2R Intermodal Inc. under this Agreement, but that any such tax obligations are the soleresponsibility of CONTRACTOR. R2R Intermodal Inc. is not authorized to withhold state of federal income tax,or Social security tax upon the sums paid CONTRATOR or CONTRACTOR’S subcontractors, agents andemployees.15. Invalidity In the event any provision of this Agreement shall be held to be invalid, it shall not affect the validity ofthe remainder of this Agreement.16. Notices Any written notice required by the terms of this Agreement shall be given either by personal delivery,by certified mall, premium overnight delivery service, telecopier or such other means as the parties shall inwriting agree upon.17. Headings The headings of this Agreement’s provisions are for convenience only and shall not control or affect themeaning or construction or limit the scope or intent of any of this Agreement’s provisions. All headings shall besubordinate to the meaning of the text of the Agreement.NAME OF CONTRACTOR’S R2R INTERMODAL INC.Business: By ____________________________________________________________________ Authorized AgentBy________________________________ (Attached Business Card of Contractor) Representative’s SignatureIts _________________________________ Representative’s TitlePlease supply Federal Employer IdentificationNumber (FEIN) Page 9 of 10

Please supply IDES Account Number, ifany _________________________________Operating Authority (if any)MC Number: _________________________ Page 10 of 10

R2R Intermodal Inc. Cell Phone Policy The rule prohibits interstate commercial motor vehicle (CMV) drivers from using hand-held cell phones while driving. Under the new rule, CMV drivers will not be able to hold, dial, or reach for a hand-held cell phone, including those with push-to-talk capability. Hands-free phone use is allowed, as is the use of CB radios and two-way radios. Specifically, the rule prohibits drivers from: Using at least one hand to hold a mobile phone to conduct a voice communication; Dialing or answering a mobile phone by pressing more than a single button, and Reaching for a mobile phone in a manner that requires the driver to maneuver so that he or she is no longer in a seated, belted, driving position. Drivers will not be able to use hand-held phones while temporarily stopped due to traffic, a traffic control device, or other momentary delays, but they will be able to use them after moving the vehicle to the side of, or off, the highway and stopping in a safe location.Disciplinary Program for Cell Phone Violation1st Violation: Written Warning / Retraining / 2 days Off2nd Violation: Review of Records / Begin Termination of EmploymentDriver Signature: ___________________________________ Date_____________Employer Signature:__________________________ Date

Unauthorized PassengersTo provide the company and employees with a clear understanding of the safety risks involved intransporting “Unauthorized Passengers” in company equipment.No employee shall transport or permit any person to be transported on/in any motor vehicle under theauthority of the company, except as defined by Federal Motor Carrier Safety Regulations, Part 392.Unless specifically authorized in writing by the company whose authority the motor carrier is operated,no employee shall transport or permit any person to be transported on/in any motor vehicle other thana bus.When such authorization is issued, it shall state the name of the person to be transported, the pointwhere the transportation is to begin and end and the date upon which such authority expires. Nowritten authorization, however, should be necessary for the transportation of: • Employees or other persons assigned to the vehicle by the company; • Any person transported when aid is being rendered in case of an accident or emergency.Employees operating company equipment must understand and abide by the policy.The company must inform all employees operating company equipment of the “UnauthorizedPassenger” policy.Employees must read and sign the acceptance document acknowledging the “Unauthorized Passenger”policy.Employees violating the “Unauthorized Passenger” policy are subject to the progressive disciplinarypolicy.Driver’s signature: _____________________Date: ______________

Pre-Employment ChecklistTraining VideoAs part of R2R’s employment screening process, driver must show adequate knowledge of rules ,regulations, and safety procedures. For training purposes R2R provides a video for drivers thatexplains basic safety, driver qualifications, and how to fill out daily driving logs.I have watched and understood “CMV Driver Basics for Entry Level Training”.Driver Signature DateTest DriveDriver is required to perform the following for an R2R representative:- A full pre-trip inspection- Hook onto chassis- Back chassis up into designated area- Demonstrate filling out a daily log and PODDriver Signature DateR2R Signature Date

MOTOR VEHICLE DRIVER’S Certification of Violations/Annual Review of Driving Record CERTIFICATION OF VIOLATIONS—COMPLETED BY DRIVERDriver Name: (Please Print) Date of EmploymentHome Terminal(City and State) Driver’s License Number State Expiration DateI certify that the following is a true and complete list of traffic violations (other than parking violations) for whichI have been convicted or forfeited bond or collateral during the past 12 months.Date of conviction Offense Location Type of motor vehicle operatedIf no violation are listed above, I certify that I have not been convicted or forfeited bond or collateral on accountof any violation required to be listed during the past 12 months.Date of certification Driver’s SignatureCOMPLETED BY MOTOR CARRIER – ANNUAL REVIEW OF DRIVING RECORDMOTOR CARRIER: Each motor carrier shall, at least once every 12 months, require each driver it employs toprepare and fumish it with a list of all violations of motor vehicle traffic laws and ordinances (other than violationsinvolving only parking) of which the driver has been convicted or on account of which he/she has forfeited bond orcollateral during the preceding 12 months.(FMCSR 391.27)I have hereby reviewed the driving record of the above named driver in accordance with section 391.25 and findthat he/she (check one):Meets minimum requirements for safe driving Is disqualified todrive a motor vehicle pursuant to Section 391.15Does not adequately meet satisfactory s afe driving performanceReviewed by: Date Signature Title Printed Name Motor Carrier Address Motor Carrier Name

LEASE AGREEMENTNote: This Lease Agreement should be maintained in the Equipment during the term of the Agreement.I. I, _________________________________________________________________________ (Carrier/Registrant) Address: _______________________________________________________________________________, and ___________________________________________________________________________(Equipment Owner) are parties to a written Lease Agreement (Agreement), whereby the Equipment Owner has leased to the Carrier certain motor vehicle equipment listed below, owned and controlled by the Equipment Owner, whereby the Equipment Owner is providing the Carrier as operator or operators of the Equipment for the purpose of loading, transporting and unloading freight.II. The Original Agreement is on file at the Carrier’s General Office. A copy of this Lease Agreement and receipt for the Equipment must be carried on the Equipment as required by 49 CFR §376. Carrier verifies that the Equipment is being operated by the Carrier, pursuant to the terms of the Agreement.III. Equipment Owner/Equipment Information Name:___________________________________ Phone #: _______________________________________ DBA: ____________________________________ Contact:________________________________________ Address: _________________________________ FEIN: __________________________________________ _________________________________Year: _______ Make: ____________________ VIN: ________________________________ Unit #: __________IV. Duration of Lease Agreement and Termination The Lease Agreement shall begin on the date below and shall remain in effect until terminated by either party, giv- ing notice to that effect. Notice may be given personally, by mail or by fax at the address or fax number shown in the Lease Agreement.MOTOR CARRIER/REGISTRANT EQUIPMENT OWNERBy: ____________________________________________ By: ____________________________________________Date: __________________________________________ Date: __________________________________________MC #:__________________________________________USDOT #: ______________________________________Printed by authority of the State of Illinois. November 2011 — 1 — VSD 683.2


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