Stronger Together, Driving Success Forward.

Contact Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type of Work

local

city

regional

long haul

Material Being Hauled

gravel

Asphalt

filll

snow

debris

Other

Driver With or Without Truck?

Driver Only

Driver + Dump Truck

Type of Truck Needed

Tri-Axle

Tandem

Pony Pup

Live Bottom

Other:

Contract Length

1 Day

1 Week

2-4 weeks

seasonal

ongoing

permanent

Start Date

MM

DD

YYYY

End Date

(If Applicable)

MM

DD

YYYY

Consent & Authorization

By submitting this form, I acknowledge and consent to the collection, storage, and use of the information provided by BAGZ INC, BAGZ TRANSPORT INC, and BAGZ GOC INC. This information may be shared internally among affiliated entities and trusted partners for the sole purpose of evaluating, sourcing, and dispatching qualified drivers and equipment to fulfill the job requirements outlined above. I understand that this information may be used to generate service agreements, coordinate operational logistics, and facilitate communication necessary to carry out the services requested. I confirm that I am authorized to make this request on behalf of the company listed.

"Yes, I agree to the collection and use of this information as outlined above by BAGZ INC, BAGZ Transport INC, and BAGZ GOC INC.”

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