Company's Authorized Representative {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Title  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

 

Company Information

Owner's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

For status updates / notifications.

{ binding firstError.message }

Company Email Address

Company Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Is the company address the same as mailing address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Provide Mailing Address below {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

 

 

Employee Policy Options

This section of the application will allow you to customize the disciplinary actions that will result from violations of the safety policy. Please ensure that the actions chosen are those that you are willing to ENFORCE with company drivers, otherwise they will present no benefit to the company.

 

Select Disciplinary Action for each item:

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

 

 
Would you like to establish rewards system for Clean Inspections? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

 

 

 

 

 

This section of the application will allow you to customize the disciplinary actions that will result from violations of the safety policy. Please ensure that the actions chosen are those that you are willing to ENFORCE with company drivers, otherwise they will present no benefit to the company.

 

 

 

 

 

 

 

 

 

 

Companies that give bonuses to drivers for clean inspections give drivers a reason to be even more thorough during DVIRs (Driver Vehicle Inspection Reports). Clean inspections help improve safety scores, which will help the company overall.

 


Enter number of drivers the policy will be distributed to:

{ binding firstError.message }

Driver Information

Driver {binding ItemNumber}

Driver's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

---To add more drivers click "Add Driver" below.

{ binding firstError.message }

 

 

 

 

Processing Fees and Delivery Options

 

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

 

 

Processing Option {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

There is additional $2 charge per driver for mailed copies. 

{ binding firstError.message }

 

 

 

 

SIGNATURE AND TERMS & CONDITIONS

 

Terms and Conditions

  • While having a safety policy on file is a n important step toward safety compliance, it is the enforcement of the policy that may have an impact on safety scores should an FMCSA Audit or Compliance Review take place.

 

  • Federal Applications Processor Hoffenmer offers this safety policy to companies as a template for their Safety Management Controls. However, Federal Applications Processor Hoffenmer cannot and will not guarantee that this policy will be sufficient to cover all aspects of safety management, nor that this template will assist with a company’s safety scores or safety rating.

 

  • A company using this policy is fully responsible for reading the contents of this policy and enforcing the guidelines as set forth.

 

  • Further, by accepting this safety policy, a company agrees to hold harmless Federal Applications Processor Hoffenmer, its subsidiaries and agents for any harm incurred by the acceptance of this policy, or its use or lack thereof.

 

{ binding firstError.message }

 

 

{ binding firstError.message }

Use your computer mouse to sign, or open the application on touch-screen device to sign with your finger.

{ binding firstError.message }
Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

 

{ binding firstError.message }

FOR INTERNAL USE ONLY. LEAVE BLANK

 

 

 

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

 

 

Company's Authorized Representative {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Title  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Other Job Title: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

Company Information

Owner's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Company Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
USDOT Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Cell Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Company Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is the company address the same as mailing address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Provide Mailing Address below {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

 

 

 

Employee Policy Options

 

Select Disciplinary Action for each item:

One Quarterly Violation {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Two Quarterly Violations {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Three Quarterly Violations {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Four Quarterly Violations {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Five Quarterly Violations {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 
Would you like to establish rewards system for Clean Inspections? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
One Clean Inspection per Quarter {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

 

 

 

 

 

 

This section of the application will allow you to customize the disciplinary actions that will result from violations of the safety policy. Please ensure that the actions chosen are those that you are willing to ENFORCE with company drivers, otherwise they will present no benefit to the company.

 

 

 

 

 

 

 

 

 

 

Companies that give bonuses to drivers for clean inspections give drivers a reason to be even more thorough during DVIRs (Driver Vehicle Inspection Reports). Clean inspections help improve safety scores, which will help the company overall.

 


Enter number of drivers the policy will be distributed to:

Enter number of drivers the policy will be distributed to_ {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Driver Information

Driver {binding ItemNumber}

Driver's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
I don't know driver's DOB. Will add later. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

---To add more drivers click "Add Driver" below.

{ binding firstError.message }

 

 

 

 

Processing Fees and Delivery Options

 

Employee Policy Application Processing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver count: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver(s) Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

 

 

Processing Option {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Additional Comments: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

There is additional $2 charge per driver for mailed copies. 

Driver Mailing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

 

 

 

 

SIGNATURE AND TERMS & CONDITIONS

 

Terms and Conditions

  • While having a safety policy on file is a n important step toward safety compliance, it is the enforcement of the policy that may have an impact on safety scores should an FMCSA Audit or Compliance Review take place.

 

  • Federal Applications Processor Hoffenmer offers this safety policy to companies as a template for their Safety Management Controls. However, Federal Applications Processor Hoffenmer cannot and will not guarantee that this policy will be sufficient to cover all aspects of safety management, nor that this template will assist with a company’s safety scores or safety rating.

 

  • A company using this policy is fully responsible for reading the contents of this policy and enforcing the guidelines as set forth.

 

  • Further, by accepting this safety policy, a company agrees to hold harmless Federal Applications Processor Hoffenmer, its subsidiaries and agents for any harm incurred by the acceptance of this policy, or its use or lack thereof.

 

I HAVE READ AND AGREE TO ABOVE TERMS AND CONDITIONS {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

Signature Only {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Signature (Type your name) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

 

Asst Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }