Driver Qualification File

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Driver Application for Employment

Personal information and employment history (49 CFR §391.21)

Full Legal Name *

Street Address *

City

State / ZIP

Phone *

Email *

Date of Birth *

SSN — Last 4 Digits Only *

CDL / License Number *

License State

License Expiration Date

License Class

Position Applied For

Years of Driving Experience

Employment History — Last 3 Years

List all employers for the past 3 years (most recent first)

No employers added. Click "+ Add Employer" to add your work history.

Motor Vehicle Record Authorization

Authorization to obtain MVR (49 CFR §391.23)

AUTHORIZATION TO OBTAIN MOTOR VEHICLE RECORD

I, the undersigned applicant, hereby authorize Wathen Logistics LLC (MC# 1578019) and its designated agents and representatives to obtain information about my driving record from any state Department of Motor Vehicles or equivalent agency.

This authorization includes, but is not limited to, records of all traffic violations, accidents, license suspensions, revocations, or other adverse actions on record with any state or federal agency.

This information will be used solely for the purpose of evaluating my qualifications for operation as a commercial motor vehicle driver or owner-operator in accordance with Federal Motor Carrier Safety Regulations (49 CFR Part 391).

I understand that this authorization remains valid for the duration of my employment or contract relationship with Wathen Logistics LLC and will be renewed annually as required by FMCSR.

I certify that the information I have provided is true and complete to the best of my knowledge.

Driver License Number *

License State *

Electronic Signature (Type Full Name) *

Typing your full name constitutes a legally binding electronic signature.

Date *

Medical Certification

DOT Medical Examiner's Certificate (49 CFR §391.43)

📋 Requirements

You must have a valid DOT Medical Examiner's Certificate issued by a FMCSA-registered medical examiner. Upload a clear photo or scan of both sides if applicable. Certificate must be current (not expired).

Medical Certificate Number

Certificate Expiration Date *

Examining Physician / Medical Examiner Name

National Registry # (NRCME)

Upload Medical Certificate (Photo or PDF) *

Click to upload or drag & drop

JPG, PNG, or PDF — max 5MB

Annual Driver Certification of Violations

Annual certification of traffic violations (49 CFR §383.31)

I certify that the following is a true and complete list of traffic violations (other than parking violations) for which I have been convicted or forfeited bond or collateral during the past 12 months:

I have NO violations to report during the past 12 months

List all traffic violations below:

Date	Violation	Location	Offense Type	Disposition
No violations added

Electronic Signature *

Date *

Road Test Certificate

Record of road test administered (49 CFR §391.31)

If you hold a valid CDL, you may be exempt from a road test. Indicate below whether a road test was administered or provide your CDL exemption information.

I hold a valid CDL — road test waived

Examiner Name

Vehicle Type Tested

Date of Test

Test Result

Examiner Signature (Type Name)

Notes / Remarks

Driver Signature (Type Full Name) *

Date *

Safety & Company Policy Acknowledgment

Acknowledgment of policies and regulations

🚦 Hours of Service (HOS) — 49 CFR Part 395

11-Hour Driving Limit: May drive a maximum of 11 hours after 10 consecutive hours off duty.
14-Hour Limit: May not drive beyond the 14th consecutive hour after coming on duty.
30-Minute Break: Must take a 30-minute break when you have driven for a period of 8 cumulative hours without at least a 30-minute interruption.
60/70-Hour Limit: May not drive after 60/70 hours on duty in 7/8 consecutive days.
ELD/AOBRD compliance required for all drivers subject to HOS rules.

🧪 Drug & Alcohol Testing — 49 CFR Part 382

Pre-employment drug testing is required before driving for Wathen Logistics.
Random drug and alcohol testing applies throughout the employment/contract period.
Post-accident testing required for any accident meeting DOT criteria.
Prohibited: Use of alcohol within 4 hours of duty; use of controlled substances at any time.
Prescription medications affecting alertness must be reported to dispatch prior to driving.
Any positive test result disqualifies the driver from operating under this MC#.

🛡️ Safety Policies

No use of handheld mobile devices while operating a commercial motor vehicle.
Pre-trip and post-trip vehicle inspections required per 49 CFR §396.13.
All accidents/incidents must be reported to dispatch immediately.
Seat belt use is mandatory at all times the vehicle is in motion.
Speed limits must be observed; no speeding citations permitted while on dispatch.
Driver is responsible for securing cargo and verifying weight limits.

📋 Owner-Operator Agreement

Owner-operators operate under Wathen Logistics MC# 1578019 and must carry required insurance.
Minimum cargo insurance: $100,000. Minimum auto liability: $750,000.
Proof of insurance must be current and on file at all times.
Settlement sheets and payment terms are per the independent contractor agreement.
Owner-operator is responsible for maintaining their vehicle in safe operating condition.
Wathen Logistics reserves the right to inspect vehicle for DOT compliance.

I have read and understand the Hours of Service regulations and agree to comply. I have read and understand the drug and alcohol testing requirements and agree to comply. I have read and understand Wathen Logistics safety policies and agree to comply. I certify that all information provided in this application is true, accurate, and complete to the best of my knowledge.

Final Electronic Signature *

Typing your name confirms your agreement to all policies above.

Date *

Owner-Operator Lease Agreement

Independent Contractor Lease — Wathen Logistics LLC (MC# 1578019)

OWNER-OPERATOR LEASE AGREEMENT

Wathen Logistics LLC · MC# 1578019 · Independent Contractor Agreement

1. PARTIES

This Lease Agreement ("Agreement") is entered into between Wathen Logistics LLC ("Carrier," MC# 1578019) and the Owner-Operator ("Contractor") identified by their signature below. This Agreement governs the lease of Contractor's equipment to Carrier and the provision of transportation services under Carrier's operating authority.

2. REVENUE SPLIT & SETTLEMENT

85% to Contractor / 15% to Wathen Logistics LLC of gross load revenue per dispatch.
Settlement payments are made weekly via direct deposit, accompanied by detailed settlement statements showing gross revenue, deductions, and net pay for each load.
Settlement statements will be provided within 15 days following each pay period.
Carrier reserves the right to deduct advances, fuel card charges, and other authorized deductions from settlement payments with Contractor's written consent.

3. TERM & TERMINATION

This Agreement commences on the date of execution and continues on an at-will basis.
Either party may terminate this Agreement with 30 days written notice.
Carrier may terminate immediately for cause, including but not limited to: violation of FMCSA regulations, drug/alcohol policy violations, safety violations, or willful misconduct.
Upon termination, Contractor shall return any Carrier-issued equipment or materials within 5 business days.

4. CONTRACTOR RESPONSIBILITIES

Fuel: Contractor is solely responsible for all fuel costs.
Maintenance: Contractor is responsible for all maintenance, repairs, and upkeep of their equipment.
Insurance: Contractor must maintain insurance as specified in Section 5 at all times.
Permits & Licensing: Contractor is responsible for all permits, licenses, and fees required to operate their equipment.
FMCSA Compliance: Contractor shall comply with all applicable Federal Motor Carrier Safety Regulations (49 CFR Parts 380–399) at all times while operating under this Agreement.
Contractor acknowledges they are an independent contractor and not an employee of Wathen Logistics LLC. Contractor is responsible for all applicable self-employment taxes and benefits.

5. INSURANCE REQUIREMENTS

Contractor must maintain the following minimum insurance coverage and provide certificates of insurance naming Wathen Logistics LLC as additional insured:

Public Liability (Auto): Minimum $1,000,000 per occurrence
Cargo Insurance: Minimum $100,000 per load
Contractor must notify Carrier immediately of any lapse in coverage. Failure to maintain required insurance is grounds for immediate termination.

6. EQUIPMENT LEASE

Contractor leases their equipment to Carrier for exclusive use during each dispatch period.
Contractor retains ownership and control of their equipment at all times outside of active dispatch.
Carrier may place identifying placards or markings on leased equipment during the lease period in compliance with FMCSA requirements (49 CFR §376).

7. INDEPENDENT CONTRACTOR STATUS

Contractor is an independent contractor and not an employee, agent, or partner of Wathen Logistics LLC. Contractor retains control over the manner and means of performing transportation services. Nothing in this Agreement creates an employment relationship. Contractor is responsible for all self-employment taxes, health insurance, and other obligations of self-employed individuals.

8. GOVERNING LAW

This Agreement is governed by the laws of the State of Maryland and applicable federal regulations, including 49 CFR Part 376 (Lease and Interchange of Vehicles).

By signing below, Contractor acknowledges they have read, understood, and agree to all terms of this Owner-Operator Lease Agreement. This electronic signature constitutes a legally binding agreement under the Electronic Signatures in Global and National Commerce Act (E-SIGN Act).

Equipment Description (Year, Make, Model, VIN) *

Describe the vehicle you are leasing to Wathen Logistics LLC under this agreement.

Contractor Signature

Contractor Full Name (Print) *

Date *

Electronic Signature (Type Full Name) *

Typing your full name constitutes a legally binding electronic signature under the E-SIGN Act.

📋 Admin Countersignature

Dale Wathen (Carrier Representative) will countersign this agreement on the admin side. A signed PDF copy will be available for download from the admin dashboard once reviewed and approved.

Direct Deposit / Banking Information

For weekly settlement payments via ACH direct deposit

💰 Weekly Settlement Payments

Wathen Logistics pays owner-operators weekly via ACH direct deposit. Provide your banking information below so we can process your settlements promptly. Upload a voided check or enter your account details manually.

Upload Voided Check (Preferred)

Click to upload voided check

JPG, PNG, or PDF — max 5MB. Write "VOID" across the check.

or enter manually

Bank Name

Routing Number (9 digits)

Found at the bottom-left of your check.

Account Number

Found at the bottom of your check, after the routing number.

Account Type

Account Holder Name

🔒 Security Notice: Your banking information is transmitted securely and used solely for processing your weekly settlement payments from Wathen Logistics LLC. This information is accessible only to authorized Wathen Logistics personnel.

Application Submitted!

Your Driver Qualification File has been received by Wathen Logistics.

Our team will review your application and contact you within 1-2 business days at the email address you provided. Questions? Call (240) 538-3658.

What Happens Next

Wathen Logistics reviews your DQF
MVR pull and background check initiated
Pre-employment drug test scheduled
Independent contractor agreement sent
First load assigned once cleared

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