Independent Delivery Contract

Personal Information

Name *
Prefix
First *
Last *
Suffix
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Cell Phone Number *

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Email Address
Driver License Number / State

INSURANCE/AVAILABILITY:

Auto Insurance Company *
Policy Number / Expiration Date
Days Available *
 Monday 
 Tuesday 
 Wednesday 
 Thursday 
 Friday 
 Saturday 
 Sunday 
 Any 
Hours Available *
 AM 
 PM 
 Any 
Streets I know best are in these counties (check all that apply) *
 Philadelphia 
 Bucks County 
 Montgomery County 
 Chester County 
 Delaware County 
 Anywhere 
Which of the following best describes your delivery vehicle. *
 Sedan 
 Hatchback 
 SUV 
 Minivan 
 Panel van 
 Other  
In the box below, please tell us if you have access for a GPS device. List the manufacturer.
Also, Please use the box for any other pertinent information.
What date are you available to start delivering? *

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This contract is an agreement between an independent contract delivery person (Driver) and Penny's by Plaza Flowers (Plaza). Driver accepts the following requirements as the minimum acceptable conditions of agreement:
 Driver posesses a valid driver's license. 
 Driver provides a fully insured vehicle with valid registration and inspection. 
 Driver accepts full liability for personal injury. 
 Driver accepts full liability for damage to vehicle or other property. 
 Driver accepts full responsibility for traffic violations and parking tickets. 
 Driver will match package order number upon arrival. 
 Driver agrees to deliver all products in the condition as they left the shop. 
 Driver agrees to allow NO SMOKING IN THE VEHICLE. 
 Driver agrees to promptly update delivery status at edelivery.eflorist.com 

Plaza and Driver accept the following conditions of compensation:

(1) 5 business days after completion of deliveries, Plaza will pay Driver for each and every delivery completed in good condition to the correct address at the correct time. Each address is considered one delivery regardless of the amount of packages.

(2) The compensation is $5.50 for every delivery in 19038, 19403, 19407, 19408, & 19409; $6.50 in 19001, 19027, 19046, 19095, 19085, 19087, 19301, 19312, 19333, 19401, 19404, 19405, 19406, 19420, 19422, 19426, 19428, 19453, 19456, 19460, 19462, & 19481; $8.50 for every delivery in the remaining zip codes.

It is hereby acknowledged that Penny's by Plaza Flowers is not liable for personal injury or vehicular damage incurred while Driver is performing duties as a contract delivery person.

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
Do you agree with the terms and conditions? *
 Yes, I agree. 
Initial *
Date *

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