Let’s work togetherInterested in working together? Fill out some info and we will be in touch shortly! We can't wait to hear from you. New Customer Application: IntermodalLandJet / 1090 Hall Ave. Jurupa Valley, CA 92509 / Tel: 1-626-333-9200 Name Of Business * First Name Last Name D & B Number * CCR Number * Tax I.D. Number * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Website http:// Type Of Business * In Business Since Legal form Under Which Business Operates: * Corporation Partnership Proprietorship If Division/Subsidiary, Name of Parent Company: Billing Information (if different) Billing Address City State Zip Phone (###) ### #### Primary Contact Name * First Name Last Name Position / Title * Email * Phone * (###) ### #### Cell (###) ### #### Fax Number Accounts Payable Contact Name * First Name Last Name Position / Title * Email * Phone (###) ### #### Cell (###) ### #### Fax Number PER DIEM INVOICE NOTICE * Please be advised that all per diem invoices received will be forwarded to your attention for confirmation of payment. You can either choose to pay invoices directly to the steamship lines or can have Landjet pay on your behalf – a 10% administration fee will be billed in this case. If you choose to pay the steamship company directly, please follow our below guidelines. You have 48hrs to respond with confirmation or we will initiate payment and rebill invoice with 10% administration fee. Direct Payment to Steamship Line: Confirmation of payment to steamship line must be made with 3 days 7 days to provide receipt of payment If invoices are not paid or resolved within 14 days, Landjet will initiate payment Admin Fee of 15% will be assessed after 14 days of non-payment Admin Fee will increase to 20% if response or confirmation is not received after 21 days Per Diem Disputes 3 Days to provide proof of dialogue communication with line 7 days to provide proof of resolution, payment and receipt If no proof of payment has been received within 14 days, Landjet will initiate payment Admin Fee of 15% will be assessed after 14 days of non-payment Admin Fee will increase to 20% if response or confirmation is not received after 21 days I have read the following and agree to the terms in the Per Diem Invoice Notice Please review our rates and accessorial fees for your lane. Rate: Drayage + FSC * -10% - Administration Fee for any SSL or port fee’s paid -$75 – Chassis/Triaxle Rental Fee Per Day -$7.50 – Prepaid Chassis Fee Per Day -$40 - Secure Storage Per Day (this includes empties) -$100 - Per Hour Wait Time at Receiver/Terminal (After 1 Hour) -$150 per hour after 3 hours wait time at Receiver/Terminal -$150 – 2nd Shift / Night Pull Fee/Empty return or delivery -$150-Weekend pull/Empty return or delivery (per container) -$100 – Pre-Pull Fee- (for containers that do not deliver direct) -$300- Pre-pull (for delivery locations in the L.A area) -$350 – Dry Run fee IE-UTL, shutout, refusal -$125- Reefer Plug In (first three days) after 3 days, $50 per day -$150-$350-Drop Fee - Applies to locations out of our drop free zone. $250 - Over 36,500lbs to 44,000 for special equipment 20' -$250 - Over 44,000lbs to 47,000 for special equipment 40' -$800 – Over 44,000 lbs. to 47,000lbs for special equipment 20’ -$800 - Over 47,000 – 50,000 lbs. overweight surcharge 40' -$100 - Cancellation fee for D/O cancelled after 72 Hours By checking this box and submitting form you are acknowledging our rate and accessorial fees and understand that additional charges may apply to your container(s). Drayage Email List * Drayage Email List Intermodal@landjet-inc.com – All import and export delivery orders must be sent to our Intermodal email address. Inquiries had regarding the status, pick-up and delivery of a container must also be sent to this address. autonotify@landjet-inc.com – All invoices will be sent from our “AutoNotify” email address. Notifications will also be sent from this address if you choose to receive automatic notifications. This is an unmonitored inbox and emails sent from this address should not be responded to. Please direct all inquiries to Intermodal@landjet-inc.com I have read dryage email list Info Auto-Notification Options Empty Availability This auto notification will be sent when an import container is empty and available. Auto-Notification: Cut-Off Date This auto notification will be sent when the cut-off date of a Vessel is established or reached. (Cutoff date is the date when all export containers must be delivered to the port for vessel loading. Auto-Notification: Delivered This auto notification will be sent when an import or export container is pre-pulled, export cargo is loaded and returned to the terminal and when an import is delivered to consignee. Auto-Notification: Demurrage Incurred This auto notification will be sent when an import LFD passes or is reestablished. Auto-Notification: Dray Delivery This auto notification will be sent when an import load is picked up from the terminal. Auto-Notification: Final Delivery This auto notification will be sent when all legs of an order have been delivered. Auto-Notification: Invoiced This auto notification will be sent when an order has been invoiced. This auto notification will be sent when an order has been invoiced. Auto-Notification: Missed Deliveries This auto notification will be sent when the scheduled delivery appointment date and time has been missed. Auto-Notification: Missed Pickups This auto notification will be sent when the scheduled pick-up appointment date and time has been missed. Auto-Notification: Order Created This auto notification will be sent when an order has been created. For both Import/Export and ECL/FCL Auto-Notification: Per Diem Incurred This auto notification will be sent when Per Diem has begun to accrue on a specific order/container. Auto-Notification: Pick Up This auto notification will be sent when an import/export order has been picked up from terminal/warehouse. Auto-Notification: Supplier Invoiced Posted This auto notification will be sent when an invoice is posted and sent. Form Authorized Signature By: First Name Last Name Date MM DD YYYY Thank you! Credit Reference ApplicationLandJet / 1090 Hall Ave. Jurupa Valley, CA 92509 / Tel: 1-626-333-9200 Name Of Business * First Name Last Name D & B Number * CCR Number * Tax I.D. Number * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Website http:// Type Of Business * In Business Since Legal form Under Which Business Operates: * Corporation Partnership Proprietorship If Division/Subsidiary, Name of Parent Company: Name of Principal Responsible for Business Transactions: Title Company Total Assets Income * Company Total Liabilities * Annual Net * Amount of Credit Requested: Is your Company subject to any litigation? * If so, Describe: Have you or your officers or affiliates ever filed a petition in bankruptcy? * If so, Describe: Form Authorized Signature By: First Name Last Name Date MM DD YYYY Trade References Company Name * Contact Name First Name Last Name Phone (###) ### #### Email Address Account Number Account Open Since? MM DD YYYY Current Balance $ Trade Reference 2 Company Name Contact Name First Name Last Name Phone (###) ### #### Email Address Account Number Account Open Since? MM DD YYYY Current Balance $ Trade Reference 3 Company Name Contact Name First Name Last Name Phone (###) ### #### Email Address Account Number Account Open Since MM DD YYYY Current Balance $ Checkbox * I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein. Thank you!
