Logistic Provide Application Form

Do you operate as a Carrier or Broker?(Required)

Carrier

Broker

Carrier Application

Carrier Legal Entity Name(Required)

(Name listed on W-9)

DBA or Trade Name

(If different from legal entity name)

Type of Legal Entity(Required)

State of Formation(Required)

Federal Employer Identification Number (FEIN), Tax Identification Number (TIN) or Employer Identification Number (EIN) of Carrier.(Required)

SCAC Code

(if available)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Carrier Contact(Required)

First Last

REGISTRATIONS AND PERMITS

DOT Number(Required)

MC Number(Required)

CA DOT #

(if applicable)

Permitted in the following States and Provinces

Hold CNTL key while making multiple selections

Accounts Receivable Contact Information

Same as Carrier Contact(Required)

Yes

Accounts Receivable Contact Name(Required)

First Last

(Who will be generating invoices?) (This is where payment will be sent)

Title(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Email(Required)

example@example.com

Performance and Capabilities

Types of Moves(Required)

Inbound

Outbound

Transfers

Drayage

Types of Equipment(Required)

Type of Tablet/Phone Used in the Truck(Required)

Android/Chrome

iOS (Apple)

Other

If requested, you or your driver(s) are able to download an app for dispatching.(Required)

Yes

Will Carrier hire any subcontractors to provide services for Sims?(Required)

Yes

For Carriers

CSA BASIC SCORES – Please provide below the average FMCSA Compliance, Safety and Accountability (“CSA”) safety program (as amended) BASIC scores from the FMCSA Safety and Fitness Electronics Records (“SAFER”) system (%) obtained in the last three (3) months for the MCP numbers for the Vendor as listed on www.ai.fmcsa.dot.gov (the aggregate average “BASIC Scores”).

DOT Safety Rating (CSA Basic)

Unsafe Driving %

HOS Compliance %

Driver Fitness %

Drug Alcohol %

Vehicle Maintenance %

The BASIC Scores for each Motor Carrier Permit (MCP) number are rated as at least "Satisfactory"?(Required)

Yes

N/A

Will Carrier borrow any Sims equipment?

Yes

Are all of Carrier's employees part owners of Carrier?

Yes

Carrier complies with insurance requirements?(Required)

Yes

Carrier understands that no Services may be provided until it complies with all insurance requirement?(Required)

Yes

Please, view insurance requirements here.

Carrier will load on Saturday if needed?(Required)

Yes

DOT hazmat carrier security certification number

TAPA (Transportation Asset Protection Association) Certified?

Yes

Smartway Transport Partner?

Yes

Department of Defense (DOD) Certified?

Yes

Drivers have TWIC (Transportation Worker Identifiation Credential) cards?

Yes

C-TPAT (Customs-Trade Partnership against Terrorism) certified?

Yes

PIP (Partner in Protection) registered?

Yes

Broker Application

Broker Legal Entity Name(Required)

(Name listed on W-9)

DBA or Trade Name

(If different from legal entity name)

Type of Legal Entity(Required)

State of Formation(Required)

Federal Employer Identification Number (FEIN), Tax Identification Number (TIN) or Employer Identification Number (EIN) of Broker.(Required)

SCAC Code

(If available)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Broker Contact(Required)

First Last

Registrations and Permits

DOT Number

(If applicable)

MC Number(Required)

CA DOT #

(If applicable)

Permitted in the following States and Provinces

Hold CNTL key while making multiple selections

Accounts Receivable Contact Information

Same as Broker Contact(Required)

Yes

Accounts Receivable Contact Name(Required)

First Last

(Who will be generating invoices?) (This is where payment will be sent)

Title(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Email(Required)

example@example.com

Performance And Capabilities

Types of Moves(Required)

Inbound

Outbound

Transfers

Drayage

Types of Equipment(Required)

Types of Tablet/Phone Used in the Truck(Required)

Android/Chrome

iOS (Apple)

Other

If requested, you or your driver(s) are able to download an app for dispatching.

Yes

Terms and Conditions and Signature

Name(Required)

First Last

Title

Phone Number(Required)

Email(Required)

Date(Required)

By signing below, Carrier represents and warrants that the information provided is true and correct as of the date of its execution and that the signatory is an authorized signatory of Carrier and has the authority to act on behalf of and to legally bind Carrier. By signing below, Carrier authorizes Sims Metal, its subsidiaries and representatives (collectively, "Sims") to obtain a business credit report from a credit bureau. This authorization is valid for purposes of verifying information provided in this Application, assessing Carrier's ability to meet its obligations to Sims or any other lawful purpose.

By signing below, Broker represents and warrants that the information provided is true and correct as of the date of its execution and that the signatory is an authorized signatory of Broker and has the authority to act on behalf of and to legally bind Broker. By signing below, Broker authorizes Sims Metal, its subsidiaries and representatives (collectively, "Sims") to obtain a business credit report from a credit bureau. This authorization is valid for purposes of verifying information provided in this Application, assessing Broker's ability to meet its obligations to Sims or any other lawful purpose.

Signature(Required)

Please, use mouse or finger (on touchscreen device) to sign in the box.

Document Upload

Please, upload completed and signed copies of the below documents

W-9 (PDF)(Required)

Max. file size: 39 MB.

Authority (PDF)(Required)

Max. file size: 39 MB.

SCAC Letter (PDF)

Max. file size: 39 MB.

COI (PDF)(Required)

Max. file size: 39 MB.

DOT SAFETY RATING (PDF)(Required)

Max. file size: 39 MB.

Broker's Surety Bond (PDF)(Required)

Max. file size: 39 MB.

Continential 48 States
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Canada - Alberta
Canada - British Columbia
Canada - Manitoba
Canada - New Brunswick
Canada - Newfoundland and Labrador
Canada - Northwest Territories
Canada - Nova Scotia
Canada - Nunavut
Canada - Ontario
Canada - Prince Edward Island
Canada - Quebec
Canada - Saskatchewan
Canada - Yukon

Continential 48 States
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Canada - Alberta
Canada - British Columbia
Canada - Manitoba
Canada - New Brunswick
Canada - Newfoundland and Labrador
Canada - Northwest Territories
Canada - Nova Scotia
Canada - Nunavut
Canada - Ontario
Canada - Prince Edward Island
Canada - Quebec
Canada - Saskatchewan
Canada - Yukon