CARRIER/SUB CONTRACTOR APP

Company Name
Federal Identification #
MC#
DOT#
First Name
Last Name
Address
 
City
State
Zip
Country
Email
Business Phone
Cell Phone
Are your resources currently available?
Have you worked with Sunterra Transport before?
If yes, please list services you have provided:
Business Size and Classification:
Are you registered with the system for award management?

Please list all state, county and local small business certifications currently held:

Services Provided:

Equipment Owned
Quantity
Other Equipment / Please List
Additional Comments
Disclaimer: By providing the information requested to Sunterra Transport, LLC., you promise that all information you provide will be accurate, current and truthful to the best of your knowledge. You further agree and acknowledge that Sunterra transport, LLC. will be relying on the information, that Sunterra transport, LLC. has no obligation to retain you as a subcontractor and that Sunterra transport, LLC. reserves the sole and exclusive right to retain any subcontractor or no subcontractors at all for a particular project. TO KNOWINGLY INPUT FALSE INFORMATION, INCLUDING, BUT NOT LIMITED TO NAME, PHONE NUMBER, ADDRESS AND COMPANY DATA IS A VERY SERIOUS AND FRAUDULENT MATTER THAT COULD RESULT IN SIGNIFICANT COSTS AND DAMAGES, AS WELL AS LOSS OF TIME, EFFORT AND EXPENSE, AND ACCORDINGLY, IF YOU PROVIDE FALSE INFORMATION YOU WILL FULLY INDEMNIFY SUNTERRA TRANSPORT, LLC. AND BE LIABLE FOR ACTUAL DAMAGES, DIRECT, PUNITIVE AND CONSEQUENTIAL, AND ANY REGULATORY OR JUDICIAL FINES OR PENALTIES THAT MAY ARISE FROM SUCH MISLEADING, HARMFUL AND FRAUDULENT INFORMATION, PLUS REASONABLE LEGAL FEES, COST AND EXPENSES RELATING THERETO.