Your Logistics Solution P.O Box 529 305 N. Center Street Statesville, NC 28687 To: Operations or Dispatch Department From: Holland TMS Fax: Re: Introduction to Holland TMS Holland Transportation Management Services, Inc, more affectionately known as Holland TMS, appreciates the opportunity to effectively assist you in utilizing your company s equipment and resources. Holland TMS is a full service transportation provider that can trace its roots back over 100 years to Holland Transfer Company, which began serving the Statesville, NC area in 1907. In 2002, Jeff Harvey, our current owner, spun-off the freight management operations as a separate entity, incorporating it in 2004. Despite our rapid growth, we still enjoy providing White Glove customer service and personal attention to every customer and carrier. Many other companies make similar claims but we deliver! With access to thousands of truckload carriers, Holland TMS moved 7,000 loads in 2010, delivering on-time more than 95% of the time. We cover the continental United States, Canada and Mexico. We have experience moving Vans, Flatbeds, and Refrigerated Units, as well as the exceptional equipment, such as double drop decks and permit loads. We know trucking and the service level you expect from a quality Transportation Management Company. First and foremost, Holland TMS exists to glorify Jesus Christ and to operate with integrity for ALL people we come in contact with each and every day. We have received numerous recognitions within the trucking industry that demonstrate our goal of excellence in sales and operations TIA Performance Certified - $100,000 Bond Internet Truckstop Diamond Broker 4 Diamonds TIA Certified Transportation Broker in office Dawn Foxx, Operation Manager US EPA SmartWay Partner Represents a more environmentally cleaner, more fuel efficient transportation option. NASTC Best Broker The C12 Group Member Christian Organization Accounts payable is consistent in paying quicker than Net30, with Fuel Advances and Quick Pay available Back Haul Program We can act as your agent and find top-paying loads through other 3PLs Other Offers We also provide LTL Freight, Global and Logistics Management MISSION STATEMENT Our reason for existence is to glorify Jesus Christ, to strive for excellent transportation solutions for our customers, to treat all people with respect, dignity and integrity, and to provide meaningful employment for our employees.
Are you interested in working with Holland TMS? It is imperative that we receive the following documents for our system: 1. Signed Carrier-Broker Agreement with each page initialed and signature on 3 rd page (Total 4 pages) (Enclosed) 2. Completed and signed W-9 3. Current copy of commercial liability and/or automobile and cargo insurance naming Holland Transportation Management Services, Inc as the certificate holder 4. Workers Compensation Certificate 5. Proof of Authority from DOT (contract or common) 6. Completed Carrier Profile (Enclosed) 7. Hazmat Certificate of Registration If an authorized carrier 8. SCAC Information 9. SmartWay Certification Holland TMS is a 24 hour facility, with Customer Service Reps available at all times. Therefore, we ask all drivers to contact (888) 400-0614 for dispatch and when loading / unloading are completed. If anything should delay the driver, please let us know immediately so we can arrange an alternate appointment. Our phone numbers are accessible 24 hours a day / 7 days a week. Please send all original bills of ladings to invoice with correct return address to our accounting department at: Holland Transportation Management Services, Inc PO Box 529 Statesville, NC 28687 If you have any concerns or questions pertaining to the requested information or Holland TMS in general, please contact our Carrier Relations CSR, April Sherrill, at (704) 872-4269 or direct at (704) 978-3281. Thank you for your cooperation and interest in working with Holland TMS. We look forward to working with your company in the near future. MISSION STATEMENT Our reason for existence is to glorify Jesus Christ, to strive for excellent transportation solutions for our customers, to treat all people with respect, dignity and integrity, and to provide meaningful employment for our employees.
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com CARRIER BROKER AGREEMENT AGREEMENT made this day of, 20, by and between (hereinafter referred to as CARRIER) and Holland Transportation Management Services, Inc., P.O. Box 529, Statesville, NC 28687 (hereinafter referred to as BROKER). WITNESSETH: 1. CARRIER is a motor contract carrier of property authorized by permit No., a copy of which permit is attached hereto and a part hereof) to provide transportation of property under contract with shippers and receivers of general commodities 2. BROKER is a motor carrier broker, licensed to arrange for the transportation of property by license No. 512837 (Sub B), a copy of which permit is attached hereto and made a part hereof) and controls the transportation of commodities to be tendered to CARRIER. NOW THEREFORE, in consideration of the representation made herein, the parties agree as follows: I. General a. In the course of its overall business, BROKER arranges for the transportation of freight and products owned or controlled by its customers for the benefit of such customers, and, accordingly, BROKER agrees to tender for highway transportation, and CARRIER agrees that it shall transport in a timely manner, shipments of such products from the origin(s) to the destination(s) as specified in the Load Confirmation form and any Addenda thereto issued by BROKER with respect to such shipments, to the extent of CARRIER s capacity and operating authority. b. All Load Confirmation forms must be issued by BROKER s Corporate Office in Statesville, NC, and executed in writing by an authorized representative of CARRIER in order to be effective for any purpose whatsoever. c. Except as otherwise provided herein, this AGREEMENT shall be effective from the date first above written and shall continue in effect thereafter until terminated, with or without the consent of the other party, by either party upon not less than thirty (30) days prior written notice to the other party. d. This AGREEMENT shall be governed by and construed in accordance with the laws of North Carolina. II. Specific obligations of CARRIER: a. At all times during the term of this Agreement, CARRIER shall maintain a DOT safety rating of Satisfactory. b. CARRIER shall at all times provide trailers, the interior of which shall be clean, odor free, dry, leak proof, free of contamination, debris and infestation. CARRIER will make no substitution of equipment or mode without specific approval from BROKER. c. Shipments delayed, refused or otherwise undeliverable must be reported to BROKER s dispatch office at 888-400-0614 as soon as any irregularity is evident. This number is monitored 24- hours a day, 7-days a week. Carrier Broker Agreement Page 1 of 4 Initials /
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com III. d. The CARRIER shall deliver original invoices, bills of lading and signed delivery receipts for all transportation services hereunder to BROKER s office at P.O. Box 529, Statesville, NC, 28687. e. Failure to issue a bill of lading does not affect the liability of the CARRIER. The CARRIER s liability shall be the same as a CARRIER s liability under #49 U.S. 14706. f. CARRIER agrees to maintain cargo insurance in the amount of at least $100,000 to compensate those parties entitled to recover under the preceding paragraph. CARRIER shall cause its insurance carrier to forward forthwith to BROKER a standard certificate of insurance which certificate shall require the insurance carrier to give BROKER written notice thirty (30) days prior to the cancellation of such cargo insurance. The cargo insurance shall be in the form required by #49 C.F.R. 1043 (b), and shall have no exclusions or restrictions that would not be accepted by the Interstate Commerce Commission for a filing under the statutory requirements of the above cited section, but shall, in all respects, be identical to the cargo insurance filed in accord with the said section. g. CARRIER agrees to maintain Commercial General Liability insurance with limits of liability of not less than $1,000,000 per occurrence. h. CARRIER s liability shall begin at the time cargo is loaded upon CARRIER s equipment at the point of origin, and continue until said cargo is delivered to the designated consignee at destination, or to any intermediate stop-off s party or interline carrier. i. CARRIER agrees to defend and hold harmless BROKER against any and all loss or damage claims on each shipment transported by CARRIER pursuant to the AGREEMENT. CARRIER further agrees to defend and hold harmless BROKER from any and all liability, costs and damages to persons and/or property arising out of CARRIER s operations hereunder, including but not limited to all road, fuel and other taxes, fees or permits, related to the shipments transported by CARRIER as arranged by BROKER. j. CARRIER will not knowingly contact the BROKER s customers (which have been introduced to CARRIER by BROKER) to solicit freight movements during the effectiveness of this Agreement and for a period of one (1) year following the cancellation thereof, without the participation of BROKER. Any violation of this provision shall result in a fee to BROKER of fifteen percent (15%) of the gross charge on any such shipment for said customer(s) for a period of three (3) years from the date of the violation. A shipper client is defined as any company the transportation of freight of which has been provided by CARRIER through the efforts of BROKER herein. Specific obligations of BROKER: a. BROKER agrees to secure at its expense and maintain in force during the term of this agreement, a surety bond in the amount now or in the future specified by the Interstate Commerce Commission. A copy of which bond is attached hereto and made a part hereof. BROKER further agrees to advise CARRIER of any change or lapse in their surety bond status. b. CARRIER will, in lieu of a surety bond, accept a legitimate trust fund agreement provided such a trust fund is of the type, form and amount approved by the Interstate Commerce Commission. Carrier Broker Agreement Page 2 of 4 Initials /
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com IV. Rates and Charges: a. BROKER agrees to pay CARRIER for the transportation of the commodities moved under the AGREEMENT in accordance with the rate set forth herein of ADDENDA thereto, within thirty (30) days of receipt by BROKER of CARRIER s invoice covering such transportation, bill(s) of lading and signed proof(s) of delivery, as long as these documents are received within thirty (30) days of the shipment date. BROKER will not pay CARRIER for any transportation or additional charges when documentation is received more than thirty (30) days after the shipment date. CARRIER holds the burden of ensuring that BROKER receives the appropriate documents in a timely manner. BROKER is required to pay CARRIER in full all correct and proper charges regardless of any default to BROKER by their customer. b. BROKER shall offer to CARRIER a series of shipments to be not less than four (4) throughout the term of the agreement. c. All Load Confirmation forms will be faxed to the CARRIER by the BROKER stating the agreed rates and will be considered a part of this AGREEMENT. d. Additional charges will only be paid after BROKER receives specific and sufficient documentation supporting such additional charges and only after verification of this supporting documentation with BROKER s customer. V. Provisions as to the settlement of Cargo Claims and other disputes: a. Cargo claims shall be settled in accordance with the regulations codified as #49 C.F.R. 370. b. The deduction of funds from CARRIER s invoice(s) is prohibited unless written permission from the CARRIER is received. VI. The relationship of the CARRIER to the BROKER shall, at all times, be that of an Independent contractor. BROKER, by its request for original documents, agrees to hold the CARRIER harmless against any and all liability that may result due to CARRIER s turnover of the said Original documents. IN WITNESS WHEREOF, the parties have set their hand this day of, 20. CARRIER: BROKER: Holland Transportation Management Services, Inc. SIGNATURE: SIGNATURE: Dawn Foxx TITLE: TITLE: Operations Manager Carrier Broker Agreement Page 3 of 4 Initials /
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com IMPORTANT INFORMATION FOR OUR CARRIERS Holland TMS expects its Carriers to operate professionally and with service excellence as their goal. We expect our Carriers to help us make our customers successful and to follow all laws and common industry practices. Carriers MUST complete a pre-trip inspection per FMCSA directives, to include a visual inspection of the trailer (wheels, mud-flaps, lights, air hoses, etc.), and check the following 1. The trailer number matches the trailer number on the BOL 2. The seal number matches the seal number on the BOL 3. If the trailer isn t sealed, open the trailer and look at the freight ensure it matches the description on the BOL 4. Call Holland TMS dispatch with any discrepancies, prior to departing the inspection site. Other Expectations The following service failures will result in Holland TMS charging fines to a Carrier o Failure to communicate (frequency, accuracy) o Late pickup or delivery Sign and return Load Confirmation sheets immediately after receipt, or risk losing the load. These Load Confirmation sheets can be provided via fax or email. Detention Pay Driver must call within an hour of arrival at customer site. The BOL must be clearly marked with appointment time, arrival date / time and departure date / time (initialed by customer representative) and faxed to (704) 872-7923 within 24 hours of Delivery. These procedures must be followed to be eligible for detention pay. Drivers arriving late are not eligible for detention pay. Power Only Carriers: Holland TMS is not in the trailer leasing business. You are expected to return the trailer promptly after delivering the original load. We understand that you may use the trailer for your backhaul, but in all cases the trailer must be returned within 72 hours of the original delivery. Maximum Layover Pay: $250.00 Carrier Broker Agreement Page 4 of 4 Initials /
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com HOLLAND TRANSPORTATION MANAGEMENT SERVICES, INC. OVERVIEW (A TIA Performance Certified Company - $100,000 bond) CARRIER REFERENCES BANK INFORMATION Holland Transfer Company First Citizens Bank P.O. Box 552 P.O. Box 909 Statesville, NC 28687 Statesville, NC 28687 800-532-0080 704-878-5912 Blackstar Logistics 7023 Neufoff Lane Charlotte, NC 28269 704-597-7200 Landstar Ligon 13410 Sutton Park Drive South Jacksonville, FL 32224 228-475-4044 A Plus Transport, Inc. 303 Gillon Rd Etoile, KY 42131 866-336-3944 MC #: 512837 Federal Tax ID #: 20-2182469 SCAC: HTMS Nature of Business Dedicated Truckload Logistics Management LTL Shipments 3PL Partner Ocean Freight Air Freight Holland TMS Dispatch: 888-400-0614, Available 24/7 ** Driver must call loaded, empty, daily **
P.O. Box 529 Statesville, NC 28687 Office: (704) 872-4269 Fax: (704) 872-7923 tms@hollandtms.com Carrier Profile Phone: 704-872-4269 Fax: 704-872-7923 In order to provide better service to our carriers, we would like to ask that you take a brief moment to complete the following lane analysis. By completing this form we will be able to inform you when loads become available along your preferred lanes. Carrier Name: Dispatcher(s): Hazmat Certified? Email: SCAC Code: Would you like to be added to our daily loads email list? EQUIPMENT # of Tractors # of 48ft dry vans # of Drivers # of 53ft dry vans # of Reefers # of Flatbeds # Plated Trailers Size of Flatbeds # of Vented Plated Trailers Size of Tarps Other Equipment Origin City Origin State Destination City LANES Destination State Outbound RPM Inbound RPM Please attach an updated copy of your insurance and authority when you return this fax. Thank You!
POLICY HL2005-01 - HOLLAND TMS QUICK PAY Issue Date: 9/20/04 Revision Date: 6/22/05 Overview: A Carrier may request to be paid more quickly than the standard Net 30 days from receipt of the original Bill of Lading. Upon request by the carrier and approval from Holland TMS, Quick Pay will be granted and a carrier will be paid within 3 to 5 business days after Holland TMS receives the original Bill of Lading and supporting documents. Holland TMS will charge the Carrier 4% of the gross amount agreed to be paid to the carrier. Requirements to receive Quick Pay on a specific load: 1. Carrier in Good Standing 2. Complete and Original Proof Of Delivery Documents delivered to Holland TMS 3. Carrier Pre-Approved for Quick Pay 4. Carrier must have Quick Pay documented on their invoice or you will not receive Quick Pay. 5. Copy of Quick Pay Approval on file at Holland TMS Carrier Quick Pay Request: Carrier Date MC# requests Quick Pay from Holland on. Checks should be forwarded to the following address - Company Name Address City, State, Zip Code I understand that by signing below I agree to a 4% charge for participating in Holland TMS's Quick Pay Program. Carrier Signature Title Holland TMS Approval for Carrier Quick Pay: Carrier Date is approved for Quick Pay effective. Proof of Delivery Documents should be forwarded to - Holland TMS ATTN: Accounts Payable (Quick Pay) P.O. Box 529 Statesville, NC 29687 Dawn Foxx Operations Manager, Holland Transportation Management Services Holland Transportation Management Services, P.O. Box 529, Statesville, NC 28687
June 04, 2012 GENE KAISER HOLLAND LOGISTICS PO BOX 552 STATESVILLE, NC 28687 CERTIFICATE OF STANDARD CARRIER ALPHA CODE (SCAC) RENEWAL The Standard Carrier Alpha Code of HTMS has been renewed for: HOLLAND TRANSPORTATION MANAGEMENT SERVICES INC PO BOX 529 STATESVILLE, NC 28687 MC-512837 This Alpha Code will apply only to the company name shown above through June 30, 2013. A renewal notice will be mailed approximately one month prior to expiration and must be returned promptly together with payment to ensure its continued validity. Should the company name or address change, please notify the National Motor Freight Association, Inc. at the address above. Alpha Codes ending with the letter "U" have been reserved for the identification of freight containers. If your Alpha Code ends with the letter "U", it should be used only for this purpose. A non-u ending Alpha Code should be obtained to satisfy other requirements such as company identification for Customs, Electronic Data Interchange, freight payments, etc. If you participate in the Bureau of Customs and Border Protection (BCBP) automated programs (ACE, AMS,CAFES, FAST, PAPS), your SCAC and related company information has been sent to BCBP electronically and is updated on a nightly basis. If you have encountered a problem using your SCAC with BCBP, or a copy this letter has been requested by BCBP, only then should you forward the requested information (email preferred as a PDF or TIF attachment) to the following address: CBP SCAC Processing Bureau of Customs and Border Protection 7681 Boston Blvd., Beauregard 1st Fl Wing A Springfield, VA 22153 AMS.SCAC@DHS.GOV NOTICE: Renewal of the above listed SCAC is unrelated to participation in the National Motor Freight Classification (NMFC). Further, it does not confer membership in the National Motor Freight Traffic Association, Inc. nor allow use of the NMFC inconnection with freight rates. For participation and membership information, please call (703) 838-1810 1001 North Fairfax Street Suite 600 Alexandria, VA 22314-1798 ph: 703.838.1810 fax: 703.683.1094 web: www.nmfta.org email: scac@nmfta.org
Bond Number: 13304 According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. It is estimated than an average of 10 minutes per response is required to complete this collection of information. This estimate includes time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Comments concerning the accuracy of this burden estimate or suggestions for reducing this burden should be directed to the Federal Highway Administration, 400 7th St., SW, Washington, D.C. 20590. B.M.C. 84 Approved by OMB (10/98) 2125-0570 Filer FHWA License No. ACCOUNT NO 28318 MC- 512837 PROPERTY BROKER S SURETY BOND UNDER 49 U.S.C. 13906 KNOW ALL MEN BY THESE PRESENTS, That we Holland Transportation Management Services, Inc. (Name of Property Broker) of 305 N. Center Street, Statesville, NC, 28677 (Street) (City) (State) (ZIP Code) as PRINCIPAL (hereinafter called Principal), and Southwest Marine and General Insurance Company a corporation, (Name of Surety) or a Risk Retention Group established under the Liability Risk Retention Act of 1986, Pub. L. 99-563, created and existing under the laws of the State of Arizona (hereinafter called Surety) are held and (State or District of Columbia) firmly bound unto the United States of America in the sum of $100,000, for which payment, well and truly to be made, we bind ourselves and our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal is or intends to become a Broker pursuant to the provisions of Title 49 U.S.C. 13903, and the rules and regulations of the Federal Highway Administration relating to insurance or other security for the protection of motor carriers and shippers, and has elected to file with the Federal Highway Administration such a bond as will ensure financial responsibility and the supplying of transportation subject to the ICC Termination Act of 1995 in accordance with contracts, agreements, or arrangements therefore, and WHEREAS, this bond is written to assure compliance by the Principal as a licensed Property Broker of Transportation by motor vehicle with 49 U.S.C. 13906(b), and the rules and regulations of the Federal Highway Administration, relating to insurance or other security for the protection of motor carriers and shippers, and shall inure to the benefit of any and all motor carriers or shippers to whom the Principal may be legally liable for any of the damages herein described. NOW, THEREFORE, the condition of this obligation is such that if the Principal shall pay or cause to be paid to motor carriers or shippers by motor vehicle any sum or sums for which the Principal may be held legally liable by reason of the Principal s failure faithfully to perform, fulfill and carry out all contracts, agreements, and arrangements made by the Principal while this bond is in effect for the supplying of transportation subject to the ICC Termination Act of 1995 under license issued to the Principal by the Federal Highway Administration, then this obligation shall be void, otherwise to remain in full force and effect. The liability of the Surety shall not be discharged by any payment or succession of payments hereunder, unless and until such payment or payments shall amount in the aggregate to the penalty of the bond, but in no event shall the Surety s obligation hereunder exceed the amount of said penalty. The Surety agrees to furnish written notice to the Federal Highway Administration forthwith of all suits filed, judgments rendered, and payments made by said Surety under this bond. This bond is effective the 7th day of December, 2012, 12:01 a.m., standard time at the address of the Principal as stated herein and shall continue in force until terminated as hereinafter provided. The principal or the Surety may at any time cancel this bond by written notice to the Federal Highway Administration at its office in Washington, D.C., such cancellation to become effective thirty (30) days after actual receipt of said notice by the FHWA on the prescribed Form BMC-36, Notice of Cancellation Motor Carrier and Broker Surety Bond. The Surety shall not be liable hereunder for the payment of any damages hereinbefore described which arise as the result of any contracts, agreements, undertakings or arrangements made by the Principal for supplying of transportation after the termination of this bond as herein provided, but such termination shall not affect the liability of the Surety hereunder for the payment of any such damages arising as the result of contracts, agreements, or arrangements made by the Principal for the supplying for transportation prior to the date such termination becomes effective. The receipt of this filing by the FHWA certifies that a broker Surety Bond has been issued by the company identified above, and that such company is qualified to make this filing under Section 387.315 of Title 49 of the Code of Federal Regulations. Page 1
Falsification of this document can result in criminal penalties prescribed under 18 U.S.C. 1001. IN WITNESS WHEREOF, the said Principal and Surety have executed this instrument on the 7th day of December, 2012. Page 2
UMBRELLA LIAB EXCESS LIAB CERTIFICATE OF LIABILITY INSURANCE OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DATE (MM/DD/YYYY) 11/23/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER National Interstate Insurance Co. 3250 Interstate Drive Richfield OH 44286 CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE FAX (A/C, No): 800-948-4453 X 138. INSURER A : National Interstate Insurance Compa 32620 INSURED 739 INSURER B : PeopLease Corporation (a PEO) INSURER C : Holland Transportation Management Services (a client of the PEO) INSURER D : 210 Wingo Way, Suite 400 INSURER E : Mount Pleasant SC 29464 INSURER F : COVERAGES CERTIFICATE NUMBER: 1319494271 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ $ DED RETENTION $ $ A WORKERS COMPENSATION WPL100000100 12/1/2012 12/1/2013 X WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 NAIC # DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Coverage is provided to the leased employees of, but not the subcontractors of Holland Transportation Management Services CERTIFICATE HOLDER CANCELLATION Holland Transportation Management Services 2088 Salisbury Highway Statesville NC 28677 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
CSA CORRECTIVE ACTION To be in compliance with FMSCA, we ask that you review your company s BASIC scores on the FMSCA comprehensive safety website. (http://www.safer.fmcsa.dot.gov). If any BASIC score is over 75, we require a corrective action letter for each of those areas. Within this letter, please provide your companies policies and procedures that have been implemented in order to correct these issues and lower your BASIC scores with CSA. Thank you for your cooperation. If you have any questions, please contact our carrier relations CSR, April Sherrill, at (704) 978-3281.