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Broker Opportunity Application Form - Complete And Submit Form Below

Our Disaster Response Team (DRT)/URT has an extensive network of insurance salvage customer’s and responds year round to incidents like hurricanes, tornados, flooding, blizzards and other natural disasters. In many events additional help is needed to recover and/or tow insurance total loss vehicles to our customers facilities. In exchange for your commitment and support, URT guarantees you a set rate per day for each day that your truck and driver are in use or deployed. Depending on the distance you send your trucks, travel compensation is also provided. See policies and procedures page. United Road Towing takes their business very seriously and currently provides outstanding service to their customers. While we are all looking for ways to diversify and grow our businesses, this is also an opportunity to help those recover who have been devastated by the ravages of Mother Nature.

Companies that sign up must meet the following qualifications:

  1.  Minimum liability coverage of $500,000 or your state minimum.
  2.  Minimum on-hook coverage of $50,000
  3.  Proof of Workers Compensation (where required)
  4.  Uniformed Drivers — ANSI 3 Vests
  5.  Well maintained equipment

Please fill out the application. When you click submit, the data will transfer to Rick Chron in email form. Feel free to contact Rick Chron if you have any questions or concerns.

Broker Agreement, Vendor Profile
Type Of Company: Sole Proprietor
If Corporation:C
Street Address:
Office Number: (e.g. 2345679876)
Cell Number: (e.g. 2345679876)
Fax Number: (e.g. 2345679876)
Email Address:
DOT Number/MC Number:
Tax ID Number:
Years In Business Under Current Name:
Fleet Size (# of units):
Fleet Capabilities: Light
Heavy Duty
If Other:
List Principal(s) / Owner(s):
Please Provide Contact Info Below, If Different Than Principal(s) / Owner(s)
First Name:
Last Name:
Office Number: (e.g. 2345679876)
Cell Number: (e.g. 2345679876)
Broker Agreement, Required Documentation
Items RequiredComments
Vendor Profile, Signed Rate Sheet, Signed Policies and Procedures documentThe rate sheet, policies and procedures document and Affidavit must be signed.
Insurance CertificatePlease request your insurance company to add URT as a certificate holder. Minimum required $500,000 general liability, $50,000 On-hook.
Signed Copy of Affidavit of Acknowledgement of ResponsibilityCompany official must acknowledge that they will be responsible for damage and that all of their drivers are familiar and intend to comply with DOT regulations, including the requirement for random drug and alcohol testing.
Completed and signed W-9(IRS Regulations require backup withholdings of any payment to a subcontractor of 30% if no W-9 is on file)
Written Substance Abuse Policy A statement from your employee handbook or similar document is sufficient.
DOT or MC#DOT or Motor Carrier # or state-issued permit #

Please Read & Check Box:I understand that checking this box constitutes my legal signature confirming I have read, acknowledge and agree to comply with the insurance requirements and other required documentation as set forth in Required Documentation.
Broker Agreement, Broker Policies And Procedures
  • Drivers must report to dispatch daily on time and follow the guidelines of the incident that may be in place. Failure to report on time daily will result in non-payment for that day and potential termination from the program.
  • Paperwork, including receipts for payouts, MUST be complete and turned in immediately when vehicle is delivered at the yard in order to be paid.
  • All brokers must present themselves in the utmost professional manner when representing us on consignments.
  • Uniformed Drivers - drivers must be clean, uniformed and wearing proper protective gear and ANSI 3 safety vests.
  • Well maintained equipment - Equipment must be legal and presentable.
  • Drivers must notify the on-site coordinator immediately the following conditions:
  • When starting a job for URT, brokers will be provided with the location where drivers are to report along with date, time and contact name(s) and phone number(s).
  • Drivers must sign the Driver Attendance log sheet when they report to the branch in the morning to pick up their first assignments.
  • Broker invoices must be sent to URT each Monday, along with the Daily Route Sheets. Payments are sent to brokers every Friday.
  • Brokers must notify URT immediately: if a driver is going to be absent, late or for any reason cannot complete a shift; if a truck breaks down; if a driver damages a vehicle; if a driver or the broker is asked to make a payout; if the driver is asked to make a recovery (driver should take pictures of the scene and request instructions from the dispatch supervisor or branch manager - pre-approval for additional compensation is required)
  • 2-car carriers should pick up 6 or more vehicles per day unless CAT conditions or long distance tows prevent it.
  • Vehicle has already been picked up
  • Vehicle not at the location given
  • Authorities will not grant access to the vehicles location
  • Authorities requesting paperwork not consistent with procedures
  • Vehicle requires recovery or extrication
  • Vehicle cannot be towed without causing additional damage
  • Upon reporting these conditions, the on-site coordinator may give the driver alternate assignments
  • A day is considered as 10 - 11 hours logged by each driver depending on conditions or traffic patterns.
  • Depending on distance, travel time will be paid to and from the site according to the following distances at the applicable rate for the truck:
  • Less than 150 miles to site = 0
  • 151 - 250 miles = .5 days travel
  • 251 - 450 miles = 1 days travel
  • 451 - 700 miles = 1.5 days travel
  • Over 700 miles = 2 days travel
The daily rate of compensation, including amounts paid for travel is considered confidential information. It will be considered a violation of this agreement for a company or its representatives, including drivers to discuss the rates or any other form of compensation with other companies or representatives of other companies including dispatchers, drivers or any other personnel from another company.
Please Read & Check Box:I understand that checking this box constitutes my legal signature confirming I have read, acknowledge and agree to comply with the terms and conditions of the Broker Policies and Procedures.
Broker Agreement, Affidavit
I, certify that will be responsible for losses or damages, without disclaimers, of the vehicles in our care, custody, and control, in conjunction with any Towing agreements between and United Road Towing. I also certify that operations and drivers are familiar with and intend to comply with the Federal Motor Carrier Safety Regulations, U.S. Department of Transportation and Federal Highway Administration rules and regulations. I further certify that has adopted a policy that is consistent with DOT regulations pertaining to the prohibitions on the use of Drugs and Alcohol by its CDL drivers. All drivers are subject to testing in accordance with the DOT regulations.

Principal or Officer:
Please Read & Check Box:I understand that by checking this box I warrant the truthfulness of the information provided in this application and I have all requisite authority to complete this application and execute all documents on behalf of the applicant. I consent for the applicant to be legally bound by all terms and conditions of each electronically signed document and by the electronic application process.

Answer The Math Security Question:
Math Problem Sample Image

Hint: The math problem below is developed in the form of characters/numbers. Utilize the image sample on the left for visual assistance. Do NOT attempt to read the small characters/numbers because it forms a math problem.

U76         LO2      
  8    5      A   OIH
  Q   SEA   GR8      
  I    I      W   LPQ
  S         YK1