Credit Application - Chemical Transportation Experts

Company Information
Company Name*
Name*
First Last
Phone*
Fax*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country

Your Billing Requirements
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Contact*
First Last
Phone*
What currency to be billed in?*
- Canadian Dollars (CDN$)
- US Dollars (USD$)
What information must be submitted by DSN tor receive prompt payment?*
- Select All
- Purchase Order Number
- Bill of Lading Number
- Other Supporting documents
Check all that are required.
What other documents are required with our invoice?
What is your estimated monthly volume with DSN?*
Can invoices be sent electronically (emailed or faxed)?*
- Yes by email
- Yes by Fax
- No
Please check all that apply.
Email*

Company Information
Type of Establishment*
- Corporation
- Proprietor
- Partnership
Choose one only.
Date Established*
MM slash DD slash YYYY
Number of Employees*
Please enter a number from 0 to 10000.
Annual Sales*
Please enter a number greater than or equal to 0.
FED ID#
MC#
Corporate Officer/Owner*
First Last
Title*
Nature of Business*
Describe business activity or products shipped.

Banking Information
Bank*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Account Number*
Bank Contact
First Last

Credit References
Note that transport industry references are required.
Do you prefer to upload a file of credit references?
You may either upload a file of credit references or submit them in the form.
- I prefer to upload a list
- I prefer to enter the references in the form
Credit Reference Upload*
Max. file size: 4 MB.
If you have a standard credit reference document feel free to upload it instead of entering individual references below.
Credit Reference #1
Company Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Credit Reference #2
Company Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Credit Reference #3
Company Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*

Additional Information
Any Additional Information?

Standard Accessorial Charges

Charge	Explanation	Amount
BLIND OR HIDDEN SHIPMENT		$50 per occurrence.
BOND CHARGE - Standard BOND CHARGE - IT / T & E	Applies to any shipment that goes into bond for any reason.	$75.00 $150.00
BORDER DELAY	Applies to any shipment where truck is detained at border due to missing or inadequate customs documentation, or if for any reason, designated customs broker does not clear shipment within 1 hour after submitting paperwork at the border.	$75.00 per hour
BORDER CROSSING FEE	For any shipment that crosses the border, there will be an additional fee.	$12.00 LTL and $35 T/L & Bulk
CANCELLED PICK-UP/DELIVERY (van and flatbed)	Applies when carrier arrives to pick-up or deliver at scheduled times and shipment is not ready to be loaded or unloaded and carrier is required to return at another time.	$75.00 plus off route miles
CROSS DOCK	Applies to any shipment that requires cross-docking.	$25.00 for 1st skid and $10.00 for each additional skid
DEMURRAGE (Trailer Only) (Van and Flatbed)	Applies when a trailer is delayed beyond standard agreed delivery times.	$50.00 per day
DETENTION / WAITING TIME	Applies to any pick-up or delivery where truck was detained longer than 1 hour for Truck-Load and 1/2 hour for Less-than Truck-Load.	$75.00 per hour, or part thereof.
DROP TRAILER (van and Fatbed)	Applies when a trailer is disconnected from power unit and left at pick-up or delivery site.	$150 plus deadhead miles
EXTRA DROP/PICK (Van and Flatbed)	Applies when carrier is required to make more than one drop/pick per shipment or for a re-delivery.	1st stop $75.00 minimum, off-route miles may apply. Additional stops are $100 for 2nd, $150 for 3rd.
FUEL SURCHARGE (FSC)	Applies to all shipments.	per DSN's published rate
HEAT	Applies to any shipment that requires heated service.	+15% (minimum charge $75)
HAZARDOUS (Van and Flatbed)	Applies to any Hazardous shipment.	+15% (minimum charge $75)
INSURANCE	Additional Cargo Insurance is available upon written request.	Please contact DSN.
LAYOVER (VAN AND FLATBED)		$300.00 per occurrence.
OFF ROUTE MILEAGE	Plus FSC	$2.10 per mile for all miles off
POWER TAILGATE	Applies when a power tailgate is required to load/unload a shipment.	$150.00
LUMPER CHARGE	Applies when extra labour is required by customer to load or unload a shipment.	$35.00 per hour,
N.S.F. FEE	Applies to any cheque returned from our bank due to insufficient funds.	$50.00 per cheque.
RE-PALLETIZATION	Labour is required to re-palletize a shipment.	$35 per hour. Minimum $50 (per person)
STRAIGHT TRUCK PICK UP/DELIVERY	Applies when a pick-up or delivery is requested at a location where tractor/trailer units are not permitted or cannot gain access.	$100.00
TARPING	Applies when driver is required to tarp a flat-bed shipment.	$100.00
TEAM SERVICE	Applies when 2 drivers are required to expedite a shipment.	Please contact DSN.
VEHICLE ORDERED-NOT USED		$250 per occurrence

I have read and understand the Standard charges.*
- Yes

Accessorial Charges for Bulk Shipments

Charge	Explanation	Amount
CANCELLED PICK-UP/DELIVERY		$400 plus off route miles.
COMPARTMENT SURCHARGE		As Quoted.
		Please contact DSN.
DEMMURAGE / WAIT TIME	2 Hours Free Loading, 2 Hours Free Unloading.	8:00 – 17:00 $95.00 per hour, no maximum.
(Tractor, Trailer, Driver)		17:00 – 8:00 $95.00 per hour, $650 maximum.
DRUM NOZZLE		$125 per occurrence
EN ROUTE ORDER RE-CONSIGNMENT		$150 per occurrence plus off route mileage charges.
EXTRA STOP CHARGE		$150.00 per stop. One hour included.
HEAT IN TRANSIT		$200.00 when requested and supplied
HEATING PRODUCT BY STEAM		Actual cost + 10% admin fee (Plus extra stop charge).
HEEL CHARGE		Actual cost + 10% admin fee.
HOSE CHARGE	Two lengths of 20 foot hose included.	$75.00 each per 20 foot length additional
LAYOVER		$650.00 per occurrence.
PUMP/COMPRESSOR OFFLOAD FEE		$75 per shipment.
REJECTED/RETURN SHIPMENTS	At destination point.	$100.00 plus applicable charges.
TRAILER SPOTTING	Applicable when (a) trailer is delayed beyond 5 pm (b) trailer is spotted for pre-loading.	$200.00 per day = Tandem
(Trailer only)		$220.00 per day = Triaxle
		$240.00 per day = Quad Axle
VEHICLE ORDERED – NOT USED		$450.00 per occurrence.
WEIGH CHARGE (OFF SITE)	Rate is subject to off route mileage plus FSC	$65.00 per occurrence.
WASH CHARGE	Unless included in rate, to be determined by Product Class	$250.00 = Common Classes $325.00 = Resins $425.00 = Coatings $350.00 = Marine Pollutant $550.00 = Phenols.

I have read and understand Bulk the charges.*
- Yes

Is your organization a chemical handler of Hazardous Materials? (A chemical handler is any entity that manufactures, distributes, ships or receives Hazardous Materials.)*
- Yes
- No
Are you a member of any of the following associations/organizations?*
- Responsible Distribution (RDC)
- National Association of Chemical Distributors (NACD)
- Custom Trade Partnership Against Terrorism (C-TPAT)
- Chemical Industry Association of Canada (CIAC)
- Society of Chemical Manufacturers and Affiliates (SOCMA)
- American Chemical Society (ACS)
- NONE OF THESE

Standard Terms and Conditions

1. Rates are discounted in exchange for a released liability value for cargo claims of $2.00 per pound maximum.
2. Payment Terms are NET 15 Days.
3. Rate quotes expire in 90 days unless otherwise specified.
4. Customer is responsible for loading and/or unloading. Pump / Compressor fees are not included in this rate.
5. Maximum loading and unloading time is 1 hour each for FTL, ½ hour each for LTL, and 2 hours each for Bulk, after which additional charges will apply.
6. Where applicable, shipments must be blocked and braced by Shipper in compliance with applicable regulations.
7. All paperwork including Customs documents and terms of sale or payment of goods remain the responsibility of the shipper and/or consignee.
8. Additional cargo insurance is available upon written request.
9. Pallet or skid quotations are based on a standard skid size of 4'x4'x6', weight not exceeding 1800 lbs.
10. Feet of trailer or lbs quotations are based on 900 lbs per linear foot of trailer.
11. Freight class and weight subject to inspection. Freight charges are to be collected according to proper description.
12. All freight claims and other transportation related liabilities are the direct responsibility of the transport carrier.
13. Extra charges shall be assessed for the services beyond specified Terms and Conditions.
14. All trans border shipments are subject to a border crossing surcharge.
15. All inter modal rates and shipments quoted are subject to the requirements of The Inter modal Safe Container Act.
16. Rates are subject to DSN standard accessorial charges
17. Rates only apply to for the specific equipment type quoted.
18. Rates are based on equipment availability.
19. These terms and conditions will apply to all shipments unless otherwise specified in writing prior to transportation of goods.
I hereby apply for a 15 day account with DSN. I understand the terms of payment on this account are Net 15 days and I agree to pay the account on that the information given herein is true and correct, and I understand that it is being used to determine my credit responsibility. DSN is authorized to obtain any information it may require relative to this application from any sources to which DSN may deem necessary and each such source is hereby authorized to provide DSN with such information. DSN is furthermore authorized to disclose, in response to direct inquiries from any other lender or any Credit Bureau, such information on my account as DSN considers appropriate, and I agree to indemnity DSN against and save DSN harmless from any and all claims in damages or otherwise arising from such disclosure on DSN's part. DSN is also authorized to retain this application. I also understand that DSN's Accessorial charges are an inherent part of DSN's billing process and agree to above accessorial charges for additional services rendered. These charges constitute an a addition to any quotation submitted by DSN. These charges will apply to any and all DSN shipments unless DSN has specifically agreed in writing to include the specific charge in the rate quotation prior to pick up of the shipment.
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Company Information

Your Billing Requirements

Company Information

Banking Information

Credit References

Credit Reference #1

Credit Reference #2

Credit Reference #3

Additional Information

Standard Accessorial Charges

Accessorial Charges for Bulk Shipments

Standard Terms and Conditions