{"id":5414,"date":"2020-07-01T15:05:29","date_gmt":"2020-07-01T22:05:29","guid":{"rendered":"http:\/\/ort.designpointdev.com\/?page_id=5414"},"modified":"2020-09-30T10:05:47","modified_gmt":"2020-09-30T17:05:47","slug":"customer-application","status":"publish","type":"page","link":"https:\/\/openroad.inc\/transportation\/connect\/customer-application\/","title":{"rendered":"Customer Application"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=&#8221;stretch_row&#8221; bg_type=&#8221;image&#8221; parallax_style=&#8221;vcpb-default&#8221; bg_image_new=&#8221;id^151|url^https:\/\/t39.0c1.mywebsitetransfer.com\/transportation\/wp-content\/uploads\/openroad-background-pattern-square-var.png|caption^null|alt^null|title^openroad-background-pattern-square-var|description^null&#8221; bg_image_size=&#8221;initial&#8221; bg_image_posiiton=&#8221;top&#8221; css=&#8221;.vc_custom_1601485543285{margin-bottom: -40px !important;padding-top: 15px !important;}&#8221;][vc_column css_animation=&#8221;bottom-to-top&#8221;]<div class=\"ult-content-box-container custom-hero-quote-box\" >\t\t<div class=\"ult-content-box\" style=\"background-color:#ffffff;box-shadow: 0px 0px 50px px #000000 ;padding-top:25px;padding-right:30px;padding-bottom:30px;padding-left:30px;-webkit-transition: all 700ms ease;-moz-transition: all 700ms ease;-ms-transition: all 700ms ease;-o-transition: all 700ms ease;transition: all 700ms ease;\"  data-hover_box_shadow=\"none\"     data-bg=\"#ffffff\" ><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_7' style='display:none'><div id='gf_7' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_7'  action='\/transportation\/wp-json\/wp\/v2\/pages\/5414#gf_7' data-formid='7' novalidate>\n        <div id='gf_progressbar_wrapper_7' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_7_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_7_59\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_59\" ><h2 class=\"gsection_title\">Contact Information<\/h2><\/li><li id=\"field_7_3\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_3\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Company Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_7_3' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_3_1_container' >\n                                        <input type='text' name='input_3.1' id='input_7_3_1' value=''   placeholder='Company Name' aria-required='true'    \/>\n                                        <label for='input_7_3_1' id='input_7_3_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Company Name<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_7_3_2_container' >\n                                        <input type='text' name='input_3.2' id='input_7_3_2' value=''   placeholder='Street Address'  aria-required='false'   \/>\n                                        <label for='input_7_3_2' id='input_7_3_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_3_3_container' >\n                                    <input type='text' name='input_3.3' id='input_7_3_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_7_3_3' id='input_7_3_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_3_4_container' >\n                                        <input type='text' name='input_3.4' id='input_7_3_4' value=''     placeholder='State' aria-required='true'    \/>\n                                        <label for='input_7_3_4' id='input_7_3_4_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_3_5_container' >\n                                    <input type='text' name='input_3.5' id='input_7_3_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_7_3_5' id='input_7_3_5_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_7_3_6_container' >\n                                        <select name='input_3.6' id='input_7_3_6'   aria-required='true'    ><option value='' selected='selected'>Country<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_7_3_6' id='input_7_3_6_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_7_10\" class=\"gfield gfield--type-text gf_left_third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_10\" ><label class='gfield_label gform-field-label' for='input_7_10'>Federal Tax ID<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_7_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_63\" class=\"gfield gfield--type-text gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_63\" ><label class='gfield_label gform-field-label' for='input_7_63'>Year Business Started<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_7_63' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_12\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_12\" ><label class='gfield_label gform-field-label' for='input_7_12'>Company Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_7_12' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Sole Proprietor' >Sole Proprietor<\/option><option value='LLC' >LLC<\/option><option value='S Corp' >S Corp<\/option><option value='C Corp' >C Corp<\/option><\/select><\/div><\/li><li id=\"field_7_6\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_6\" ><label class='gfield_label gform-field-label' for='input_7_6'>Is your billing address the same as your street address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_7_6' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_7_5\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_5\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Billing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_7_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_7_5_1' value=''   placeholder='Company Name' aria-required='true'    \/>\n                                        <label for='input_7_5_1' id='input_7_5_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Company Name<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_7_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_7_5_2' value=''   placeholder='Billing Address'  aria-required='false'   \/>\n                                        <label for='input_7_5_2' id='input_7_5_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_7_5_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_7_5_3' id='input_7_5_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_5_4_container' >\n                                        <input type='text' name='input_5.4' id='input_7_5_4' value=''     placeholder='State' aria-required='true'    \/>\n                                        <label for='input_7_5_4' id='input_7_5_4_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_7_5_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_7_5_5' id='input_7_5_5_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_7_5_6_container' >\n                                        <select name='input_5.6' id='input_7_5_6'   aria-required='true'    ><option value='' selected='selected'>Country<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_7_5_6' id='input_7_5_6_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_7_72\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_72\" ><label class='gfield_label gform-field-label' for='input_7_72'>Do you accept invoices via email?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_72' id='input_7_72' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_7_7\" class=\"gfield gfield--type-email gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_7\" ><label class='gfield_label gform-field-label' for='input_7_7'>Billing Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_7_7' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_7_23\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_23\" ><label class='gfield_label gform-field-label' for='input_7_23'>May we exclude bills of lading from your invoice to process a payment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_7_23' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_7_26\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_26\" ><label class='gfield_label gform-field-label' for='input_7_26'>Do you have the ability to pay via ACH?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_7_26' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_7_13\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_13\" ><h2 class=\"gsection_title\">Accounts Payable<\/h2><\/li><li id=\"field_7_14\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_14\" ><label class='gfield_label gform-field-label' for='input_7_14'>Contact Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_7_14' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_50\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_50\" ><label class='gfield_label gform-field-label' for='input_7_50'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_50' id='input_7_50' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_7_15\" class=\"gfield gfield--type-phone gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_15\" ><label class='gfield_label gform-field-label' for='input_7_15'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_15' id='input_7_15' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_7_16\" class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_16\" ><label class='gfield_label gform-field-label' for='input_7_16'>Extension<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_7_16' type='text' value='' class='small'    placeholder='optional'  aria-invalid=\"false\"   \/> <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_7_67' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_2' class='gform_page' data-js='page-field-id-67' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_7_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_7_28\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_28\" ><h2 class=\"gsection_title\">Credit References<\/h2><\/li><li id=\"field_7_29\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_29\" ><b>Minimum of two required.<\/b><\/li><li id=\"field_7_69\" class=\"gfield gfield--type-list gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_69\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Reference One<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_69_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_69_col_2' class='gfield_list_col_even' \/><col id='gfield_list_69_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_69_col_4' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">Company Name<\/th><th scope=\"col\">Contact Name<\/th><th scope=\"col\">Phone<\/th><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_69_cell1' data-label='Company Name'><input aria-invalid='false' aria-required=\"true\"  aria-label='Company Name, Row 1' data-aria-label-template='Company Name, Row {0}' type='text' name='input_69[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_69_cell2' data-label='Contact Name'><input aria-invalid='false' aria-required=\"true\"  aria-label='Contact Name, Row 1' data-aria-label-template='Contact Name, Row {0}' type='text' name='input_69[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_69_cell3' data-label='Phone'><input aria-invalid='false' aria-required=\"true\"  aria-label='Phone, Row 1' data-aria-label-template='Phone, Row {0}' type='text' name='input_69[]' value=''   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_7_71\" class=\"gfield gfield--type-list gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_71\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Reference Two (Click the + to add additional references)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_71_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_71_col_2' class='gfield_list_col_even' \/><col id='gfield_list_71_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_71_col_4' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">Company Name<\/th><th scope=\"col\">Contact Name<\/th><th scope=\"col\">Phone<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_71_cell1' data-label='Company Name'><input aria-invalid='false' aria-required=\"true\"  aria-label='Company Name, Row 1' data-aria-label-template='Company Name, Row {0}' type='text' name='input_71[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_71_cell2' data-label='Contact Name'><input aria-invalid='false' aria-required=\"true\"  aria-label='Contact Name, Row 1' data-aria-label-template='Contact Name, Row {0}' type='text' name='input_71[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_71_cell3' data-label='Phone'><input aria-invalid='false' aria-required=\"true\"  aria-label='Phone, Row 1' data-aria-label-template='Phone, Row {0}' type='text' name='input_71[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/openroad.inc\/transportation\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/openroad.inc\/transportation\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_7_64\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_64\" ><label class='gfield_label gform-field-label' for='input_7_64'>Requested Credit Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_64' id='input_7_64' type='text' step='any'   value='' class='medium'    placeholder='$'  aria-invalid=\"false\"  \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_68' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_7\").val(\"1\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"1\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_7_68' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_3' class='gform_page' data-js='page-field-id-68' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_7_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_7_62\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_62\" ><h2 class=\"gsection_title\">Terms and Conditions<\/h2><\/li><li id=\"field_7_65\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_65\" ><label class='gfield_label gform-field-label' for='input_7_65'>Do you ship internationally?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_65' id='input_7_65' class='small gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select One<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_7_74\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_74\" ><label class='gfield_label gform-field-label' >Do you wish to purchase cargo insurance from OpenRoad Transporttaion?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_7_74'>\n\t\t\t<li class='gchoice gchoice_7_74_0'>\n\t\t\t\t<input name='input_74' type='radio' value='Yes, please quote me the cost per shipment'  id='choice_7_74_0'    \/>\n\t\t\t\t<label for='choice_7_74_0' id='label_7_74_0' class='gform-field-label gform-field-label--type-inline'>Yes, please quote me the cost per shipment<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_7_74_1'>\n\t\t\t\t<input name='input_74' type='radio' value='No, I have my own insurance.'  id='choice_7_74_1'    \/>\n\t\t\t\t<label for='choice_7_74_1' id='label_7_74_1' class='gform-field-label gform-field-label--type-inline'>No, I have my own insurance.<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_7_74_2'>\n\t\t\t\t<input name='input_74' type='radio' value='No, I will self-insure and understand my exposure to loss, including a &lt;a href=&quot;http:\/\/www.duhaime.org\/LegalDictionary\/G\/GeneralAverage.aspx&quot; target=&quot;_blank&quot;&gt;general average&lt;\/a&gt; declaration.'  id='choice_7_74_2'    \/>\n\t\t\t\t<label for='choice_7_74_2' id='label_7_74_2' class='gform-field-label gform-field-label--type-inline'>No, I will self-insure and understand my exposure to loss, including a <a href=\"http:\/\/www.duhaime.org\/LegalDictionary\/G\/GeneralAverage.aspx\" target=\"_blank\">general average<\/a> declaration.<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_7_66\" class=\"gfield gfield--type-section gsection gf_scroll_text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_66\" ><h2 class=\"gsection_title\"><\/h2><div class='gsection_description' id='gfield_description_7_66'><strong>Additional Terms and Conditions for International Shippers<\/strong>\n<\/br>\n<\/br>\nThese terms and conditions of service constitute a legally binding contract between the \"Company\" and the \"Customer\". In the event the Company renders services and issues a document containing Terms and Conditions governing such services, the Terms and Conditions set forth in such other document(s) shall govern those services.\n&nbsp;\n&nbsp;\n<ol>\n \t<li><strong>1. Definitions<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. \"Company\" shall mean OpenRoad Transportation, Inc. its subsidiaries, related companies, agents and\/or representatives.<\/li>\n \t<li>b. \"Customer\" shall mean the person for which the Company is rendering service, as well as its principals, agents and\/or representatives, including, but not limited to, shippers, importers, exporters, carriers, secured parties, warehousemen, buyers and\/or sellers, shipper's agents, insurers and underwriters, break-bulk agents, consignees, etc. It is the responsibility of the Customer to provide notice and copy(s) of these terms and conditions of service to all such agents or representatives.<\/li>\n \t<li>c. \"Documentation\" shall mean all information received directly or indirectly from Customer, whether in paper or electronic form.<\/li>\n \t<li>d. \"Ocean Transportation Intermediaries\" (\"OTI\") shall include an \"ocean freight forwarder\" and a \"non-vessel operating carrier;\"<\/li>\n \t<li>e. \"Third parties\" shall include, but not be limited to, the following: \"carriers, truckmen, cartmen, lightermen, forwarders, OTIs, customs brokers, agents, warehousemen and others to which the goods are entrusted for transportation, cartage, handling and\/or delivery and\/or storage or otherwise\".<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>2. Company as agent<\/strong><strong>. <\/strong>\n<ol>\n \t<li>a. The Company acts as the \"agent\" of the Customer for the purpose of performing duties in connection with the entry and release of goods, post entry services, the securing of export licenses, the filing of export and security documentation on behalf of the Customer and other dealings with Government Agencies, or for arranging for transportation services or other logistics services in any capacity other than as a carrier.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>3. Limitation of Actions.<\/strong>\n<ol>\n \t<li>a. Unless subject to a specific statute or international convention, all claims against the Company for a potential or actual loss, must be made in writing and received by the Company, within 30 days of the event giving rise to claim; the failure to give the Company timely notice shall be a complete defense to any suit or action commenced by Customer.<\/li>\n \t<li>b. All suits against Company must be filed and properly served on Company as follows:\n<ul>\n \t<li>(a) For claims arising out of ocean transportation, within one (1) year from the date of the loss,<\/li>\n \t<li>(b) For claims arising out of air or surface transportation, within two (2) years from the date of the loss,<\/li>\n \t<li>(c) For claims arising out of the preparation and\/or submission of an import entry(s), within seventy-five (75) days from the date of liquidation of the entry(s),<\/li>\n \t<li>(d) For any and all other claims of any other type, within two (2) years from the date of the loss or damage.<\/li>\n<\/ul>\n<\/li>\n \t<li><strong>4. No Liability for The Selection or Services of Third Parties and\/or Routes<\/strong><strong>. <\/strong>\n<ol>\n \t<li>a. Unless services are performed by persons or firms engaged pursuant to express written instructions from the Customer, Company shall use reasonable care in its selection of third parties, or in selecting the means, route and procedure to be followed in the handling, transportation, clearance and delivery of the shipment; advice by the Company that a particular person or firm has been selected to render services with respect to the goods, shall not be construed to mean that the Company warrants or represents that such person or firm will render such services nor does Company assume responsibility or liability for any actions(s) and\/or inaction(s) of such third parties and\/or its agents, and shall not be liable for any delay or loss of any kind, which occurs while a shipment is in the custody or control of a third party or the agent of a third party; all claims in connection with the Act of a third party shall be brought solely against such party and\/or its agents; in connection with any such claim, the Company shall reasonably cooperate with the Customer, which shall be liable for any charges or costs incurred by the Company.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>5. Quotations Not Binding. <\/strong>\n<ol>\n \t<li>a. Quotations as to fees, rates of duty, freight charges, insurance premiums or other charges given by the Company to the Customer are for informational purposes only and are subject to change without notice; no quotation shall be binding upon the Company unless the Company in writing agrees to undertake the handling or transportation of the shipment at a specific rate or amount set forth in the quotation and payment arrangements are agreed to between the Company and the Customer.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>6. Reliance on Information Furnished<\/strong>\n<ol>\n \t<li>a. Customer acknowledges that it is required to review all documents and declarations prepared and\/or filed with U.S. Customs &amp; Border Protection, other Government Agency and\/or third parties, and will immediately advise the Company of any errors, discrepancies, incorrect statements, or omissions on any declaration or other submission filed on Customers behalf;<\/li>\n \t<li>b. In preparing and submitting customs entries, export declarations, applications, security filings, documentation and\/or other required data, the Company relies on the correctness of all documentation, whether in written or electronic format, and all information furnished by Customer; Customer shall use reasonable care to ensure the correctness of all such information and shall indemnify and hold the Company harmless from any and all claims asserted and\/or liability or losses suffered by reason of the Customer's failure to disclose information or any incorrect, incomplete or false statement by the Customer or its agent, representative or contractor upon which the Company reasonably relied. The Customer agrees that the Customer has an affirmative non-delegable duty to disclose any and all information required to import, export or enter the goods.<\/li>\n \t<li>c. Customer acknowledges that it is required to provide verified weights obtained on calibrated, certified equipment of all cargo that is to be tendered to steamship lines and represents that Company is entitled to rely on the accuracy of such weights and to counter -sign or endorse it as agent of Customer in order to provide the certified weight to the steamship lines. The Customer agrees that it shall indemnify and hold the Company harmless from any and all claims, losses, penalties or other costs resulting from any incorrect or questionable statements of the weight provided by the Customer or its agent or contractor on which the Company relies.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>7. Declaring Higher Value to Third Parties.<\/strong>\n<ol>\n \t<li>a. Third parties to whom the goods are entrusted may limit liability for loss or damage; the Company will request excess valuation coverage only upon specific written instructions from the Customer, which must agree to pay any charges therefore; in the absence of written instructions or the refusal of the third party to agree to a higher declared value, at Company's discretion, the goods may be tendered to the third party, subject to the terms of the third party's limitations of liability and\/or terms and conditions of service.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>8. Insurance<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. Unless requested to do so in writing and confirmed to Customer in writing, Company is under no obligation to procure insurance on Customer's behalf; in all cases, Customer shall pay all premiums and costs in connection with procuring requested insurance.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>9. Disclaimers; Limitation of Liability.<\/strong>\n<ol>\n \t<li>a. Except as specifically set forth herein, Company makes no express or implied warranties in connection with its services.<\/li>\n \t<li>b. In connection with all services performed by the Company, Customer may obtain additional liability coverage, up to the actual or declared value of the shipment or transaction, by requesting such coverage and agreeing to make payment therefor, which request must be confirmed in writing by the Company prior to rendering services for the covered transaction(s).<\/li>\n \t<li>c. In the absence of additional coverage under (b) above, the Company's liability shall be limited to the following:\n<ul>\n \t<li>(a) where the claim arises from activities other than those relating to customs business, $ 50.00 per shipment or transaction, or<\/li>\n \t<li>(b) where the claim arises from activities relating to \"Customs business,\" $ 50.00 per entry or the amount of brokerage fees paid to Company for the entry, whichever is less.<\/li>\n<\/ul>\n<\/li>\n \t<li>d. In no event shall Company be liable or responsible for consequential, indirect, incidental, statutory or punitive damages, even if it has been put on notice of the possibility of such damages, or for the acts of third parties.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>10. Advancing Money<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. All charges must be paid by Customer in advance unless the Company agrees in writing to extend credit to customer; the granting of credit to a Customer in connection with a particular transaction shall not be considered a waiver of this provision by the Company.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>11. Indemnification\/Hold Harmless.<\/strong>\n<ol>\n \t<li>a. The Customer agrees to indemnify, defend, and hold the Company harmless from any claims and\/or liability, fines, penalties and\/or attorneys' fees arising from the importation or exportation of customers merchandise and\/or any conduct of the Customer, including but not limited to the inaccuracy of entry, export or security data supplied by Customer or its agent or representative, which violates any Federal, State and\/or other laws, and further agrees to indemnify and hold the Company harmless against any and all liability, loss, damages, costs, claims, penalties, fines and\/or expenses, including but not limited to reasonable attorney's fees, which the Company may hereafter incur, suffer or be required to pay by reason of such claims; in the event that any claim, suit or proceeding is brought against the Company, it shall give notice in writing to the Customer by mail at its address on file with the Company.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>12. C.O.D. or Cash Collect Shipments.<\/strong>\n<ol>\n \t<li>a. Company shall use reasonable care regarding written instructions relating to \"Cash\/Collect on Deliver (C.O.D.)\" shipments, bank drafts, cashier's and\/or certified checks, letter(s) of credit and other similar payment documents and\/or instructions regarding collection of monies but shall not have liability if the bank or consignee refuses to pay for the shipment.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>13. Costs of Collection<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. In any dispute involving monies owed to Company, the Company shall be entitled to all costs of collection, including reasonable attorney's fees and interest at 1.5% per month (18% per annum) or the highest rate allowed by law, whichever is less unless a lower amount is agreed to by Company.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>14. General Lien and Right to Sell Customer's Property.<\/strong>\n<ol>\n \t<li>a. Company shall have a continuing lien on any and all property and documents relating thereto of Customer coming into Company's actual or constructive possession, custody or control or en-route, which lien shall survive delivery, for all charges, expenses or advances owed to Company with regard to the shipment on which the lien is claimed, a prior shipment(s) and\/or both. Customs duties, transportation charges, and related payments advanced by the Company shall be deemed paid in trust on behalf of the Customer and treated as pass through payments made on behalf of the Customer for which the Company is acting as a mere conduit.<\/li>\n \t<li>b. Company shall provide written notice to Customer of its intent to exercise such lien, the exact amount of monies due and owing, as well as any on -going storage or other charges; Customer shall notify all parties having an interest in its shipment(s) of Company's rights and\/or the exercise of such lien.<\/li>\n \t<li>c. Unless, within thirty days of receiving notice of lien, Customer posts cash or letter of credit at sight, or, if the amount due is in dispute, an acceptable bond equal to 110% of the value of the total amount due, in favor of Company, guaranteeing payment of the monies owed, plus all storage charges accrued or to be accrued, Company shall have the right to sell such shipment(s) at public or private sale or auction and any net proceeds remaining thereafter shall be refunded to Customer.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>15. No Duty to Maintain Records For Customer.<\/strong>\n<ol>\n \t<li>a. Customer acknowledges that pursuant to Sections 508 and 509 of the Tariff Act, as amended, (19 USC \u00a71508 and 1509) it has the duty and is solely liable for maintaining all records required under the Customs and\/or other Laws and Regulations of the United States; unless otherwise agreed to in writing, the Company shall only keep such records that it is required to maintain by Statute(s) and\/or Regulation(s), but not act as a \"recordkeeper\" or \"recordkeeping agent\" for Customer.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>16. Obtaining Binding Rulings, Filing Protests, etc<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. Unless requested by Customer in writing and agreed to by Company in writing, Company shall be under no obligation to undertake any pre- or post-Customs release action, including, but not limited to, obtaining binding rulings, advising of liquidations, filing of petition(s) and\/or protests, etc.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>17. No Duty to Provide Licensing Authority.<\/strong>\n<ol>\n \t<li>a. Unless requested by Customer in writing and agreed to by the Company in writing, Company shall not be responsible for determining licensing authority or obtaining any license or other authority pertaining to the export from or import into the United States.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>18. Preparation and Issuance of Bills of Lading.<\/strong>\n<ol>\n \t<li>a. Where Company prepares and\/or issues a bill of lading, Company shall be under no obligation to specify thereon the number of pieces, packages and\/or cartons, etc.; unless specifically requested to do so in writing by Customer or its agent and Customer agrees to pay for same, Company shall rely upon and use the cargo weight supplied by Customer.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>19. No Modification or Amendment Unless Written.<\/strong>\n<ol>\n \t<li>a. These terms and conditions of service may only be modified, altered or amended in writing signed by both Customer and Company; any attempt to unilaterally modify, alter or amend same shall be null and void.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>20. Compensation of Company.<\/strong>\n<ol>\n \t<li>a. The compensation of the Company for its services shall be included with and is in addition to the rates and charges of all carriers and other agencies selected by the Company to transport and deal with the goods and such compensation shall be exclusive of any brokerage, commissions, dividends, or other revenue received by the Company from carriers, insurers and others in connection with the shipment. On ocean exports, upon request, the Company shall provide a detailed breakout of the components of all charges assessed and a true copy of each pertinent document relating to these charges. In any referral for collection or action against the Customer for monies due the Company, upon recovery by the Company, the Customer shall pay the expenses of collection and\/or litigation, including a reasonable attorney fee.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>21. Force Majeure<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. Company shall not be liable for losses, damages, delays, wrongful or missed deliveries or nonperformance, in whole or in part, of its responsibilities under the Agreement, resulting from circumstances beyond the control of either Company or its sub -contractors, including but not limited to:\n<ul>\n \t<li>(a) acts of God, including flood, earthquake, storm, hurricane, power failure or other natural disaster,<\/li>\n \t<li>(b) war, hijacking, robbery, theft or terrorist activities,<\/li>\n \t<li>(c) incidents or deteriorations to means of transportation,<\/li>\n \t<li>(d) embargoes,<\/li>\n \t<li>(e) civil commotions or riots,<\/li>\n \t<li>(f) defects, nature or inherent vice of the goods,<\/li>\n \t<li>(g) acts, breaches of contract or omissions by Customer, Shipper, Consignee or anyone else who may have an interest in the shipment,<\/li>\n \t<li>(h) acts by any government or any agency or subdivision thereof, including denial or cancellation of any import\/export or other necessary license; or<\/li>\n \t<li>(i) strikes, lockouts or other labor conflicts.<\/li>\n<\/ul>\n<\/li>\n \t<li><strong>22. Severability <\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. In the event any Paragraph(s) and\/or portion(s) hereof is found to be invalid and\/or unenforceable, then in such event the remainder hereof shall remain in Full force and effect. Company's decision to waive any provision herein, either by conduct or otherwise, shall not be deemed to be a further or continuing waiver of such provision or to otherwise waive or invalidate any other provision herein.<\/li>\n<\/ol>\n<\/li>\n \t<li><strong>23. Governing Law; Consent to Jurisdiction and Venue<\/strong><strong>.<\/strong>\n<ol>\n \t<li>a. These terms and conditions of service and the relationship of the parties shall be construed according to the laws of the State of Oregon without considering principles of conflict of law. Customer and Company\n<ul>\n \t<li>(a) irrevocably consent to the jurisdiction of the appropriate Oregon State Court, or United States District Court, located in Polk County, Oregon, USA,<\/li>\n \t<li>(b) agree that any action relating to the services performed by Company, shall only be brought in said courts,<\/li>\n \t<li>(c) consent to the exercise of in personam jurisdiction by said courts over it, and<\/li>\n \t<li>(d) further agree that any action to enforce a judgment may be instituted in any jurisdiction<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n&nbsp;\n\n<em>\u00a9Approved by the National Customs Brokers and Forwarders <\/em><em>Association of America, Inc. (Revised 6\/16)<\/em>\n<\/br><\/div><\/li><li id=\"field_7_42\" class=\"gfield gfield--type-section gsection gf_scroll_text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_42\" ><h2 class=\"gsection_title\"><\/h2><div class='gsection_description' id='gfield_description_7_42'><strong>General Terms and Conditions<\/strong>\n<\/br>\n<\/br>\n&nbsp;\nThese General Terms and Conditions (\u201cGeneral Terms\u201d) apply to all transportation services provided by OpenRoad Transportation, Inc. <\/br>\n<\/br>\n1. Customer affirms that information furnished in this application is current and accurate. The term of this agreement will be for one (1) year and will automatically renew for successive one (1) year periods, unless terminated by either party by providing 30 days written notice to the other party. If the parties continue to conduct business after termination, the provisions of this agreement will continue to apply.  <\/br>\n<\/br>\n2. OpenRoad Transportation, Inc. payment receiving terms are NET 30 days from invoice date, and a finance charge of 2% per month (24% APR) is added to accounts 30 days or more past due. If OpenRoad Transportation, Inc. uses a collection agency or attorney to collect any amounts due, Customer agrees to pay all associated collection costs, attorney fees, and court costs.  <\/br>\n<\/br>\n3. Customer affirms that it is solvent, is not currently a party to any bankruptcy proceeding, is not being dissolved or otherwise liquidating its assets, and can satisfy all financial obligations to OpenRoad Transportation, Inc. Customer affirms that there are no open judgments, suits, or liens against Customer.  <\/br>\n<\/br>\n4. Customer will promptly notify OpenRoad Transportation, Inc. of any material change in ownership.  <\/br>\n<\/br>\n5. OpenRoad Transportation, Inc. is a transportation broker only who arranges the transportation of freight by independent third-party motor carriers (\u201cContract Carriers\u201d). Customer agrees that if OpenRoad Transportation, Inc. is listed on Bills of Lading, it is for convenience only and does not change OpenRoad Transportation\u2019s status as a broker only.  <\/br>\n<\/br>\n6. Customer consents to OpenRoad Transportation, Inc. recording of phone calls for quality assurance and training purposes.  <\/br>\n<\/br>\n7. OpenRoad Transportation, Inc. may assist in processing claims for cargo loss, shortage, or damage, but Customer must file cargo claims with OpenRoad Transportation, Inc. within one (1) month from the date of such loss, shortage, or damage, which for purposes of this agreement will be the delivery date or, in the event of non-delivery, the scheduled delivery date. Customer will fully cooperate with OpenRoad Transportation, Inc. in processing Customer\u2019s cargo claims. If OpenRoad Transportation, Inc. pays a claim, Customer automatically assigns any and all of its rights and interest in the claim to OpenRoad Transportation, Inc.<\/br>\n<\/br>\n8. OpenRoad Transportation\u2019s Contract Carriers are required to maintain cargo insurance in the amount of $100,000 per load. Customer will not tender loads valued in excess of $100,000 without first giving OpenRoad Transportation, Inc. sufficient written notice to arrange for increased insurance limits. Failure to provide such written notice prior to tender will result in Customer\u2019s loads being insured to a maximum of $100,000.  <\/br>\n<\/br>\n9. The state courts located in Polk County, Oregon will have exclusive and irrevocable jurisdiction over and will be the exclusive and mandatory venue for any claim, counterclaim, dispute, or lawsuit arising in connection with any transactions, loads, or other business between OpenRoad Transportation, Inc. and Customer.  <\/br>\n<\/br>\n10. Customer agrees to indemnify, defend, and hold OpenRoad Transportation, Inc. harmless for Customer\u2019s negligence, willful misconduct, and\/or breach of this agreement to the fullest extent of the law.  .<\/br>\n<\/br>\n11. By signing below, Customer acknowledges that the individual executing this agreement has authority to do so and further authorizes OpenRoad Transportation, Inc. to contact each credit\/bank reference provided.<\/div><\/li><li id=\"field_7_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_44\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Check the box to proceed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_7_44'><li class='gchoice gchoice_7_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='I accept the Terms and Conditions contained in this Agreement'  id='choice_7_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_44_1' id='label_7_44_1' class='gform-field-label gform-field-label--type-inline'>I accept the Terms and Conditions contained in this Agreement<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_7_45\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_45\" >*By selecting \"accept\" above and submit below, I am signing this Agreement electronically. I agree my electronic signature is the legal equivalent of my manual signature on this Agreement. By selecting \"I accept\" I, and the company\/entity I have the authority to bind, consent to be legally bound by this Agreement's terms and conditions.<\/li><li id=\"field_7_46\" class=\"gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_46\" ><label class='gfield_label gform-field-label' for='input_7_46'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_7_46' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_47\" class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_47\" ><label class='gfield_label gform-field-label' for='input_7_47'>Position<\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_7_47' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_49\" class=\"gfield gfield--type-email gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_49\" ><label class='gfield_label gform-field-label' for='input_7_49'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_49' id='input_7_49' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_7_48\" class=\"gfield gfield--type-date gfield--input-type-datefield gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_48\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_7_48' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_48_1_container'>\n                                            <input type='number' maxlength='2' name='input_48[]' id='input_7_48_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_48_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_48_2_container'>\n                                            <input type='number' maxlength='2' name='input_48[]' id='input_7_48_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_48_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_48_3_container'>\n                                            <input type='number' maxlength='4' name='input_48[]' id='input_7_48_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                            <label for='input_7_48_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/div><\/li><li id=\"field_7_53\" class=\"gfield gfield--type-phone gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_53\" ><label class='gfield_label gform-field-label' for='input_7_53'>Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_53' id='input_7_53' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_7_54\" class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_54\" ><label class='gfield_label gform-field-label' for='input_7_54'>Extension<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_7_54' type='text' value='' class='small'    placeholder='optional'  aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_61\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_61\" ><h2 class=\"gsection_title\">Referral Information<\/h2><\/li><li id=\"field_7_55\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_55\" ><label class='gfield_label gform-field-label' for='input_7_55'>OpenRoad Transportation was referred by:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_7_55' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select one<\/option><option value='Google Search' >Google Search<\/option><option value='Current Customer' >Current Customer<\/option><option value='O' >O<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_7_56\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_56\" ><label class='gfield_label gform-field-label' for='input_7_56'>Current Customer Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_7_56' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_57\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_57\" ><label class='gfield_label gform-field-label' for='input_7_57'>Agent Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_7_57' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_58\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_58\" ><label class='gfield_label gform-field-label' for='input_7_58'>Please specify<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_7_58' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_75\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_75\" ><label class='gfield_label gform-field-label' for='input_7_75'>Want to receive monthly global forwarding news? Enter your email:<\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_7_75' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_7_73\" class=\"gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_73\" ><label class='gfield_label gform-field-label' for='input_7_73'>CAPTCHA<\/label><div id='input_7_73' class='ginput_container ginput_recaptcha' data-sitekey='6LdoWPgZAAAAAFfyCeOXWkN1xDereZXE0vqTKgwD'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><li id=\"field_7_76\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_7_76\" ><label class='gfield_label gform-field-label' for='input_7_76'>Email<\/label><div class='ginput_container'><input name='input_76' id='input_7_76' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_7_76'>This field is for validation purposes and should be left unchanged.<\/div><\/li><\/ul><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_7' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='if(window[\"gf_submitting_7\"]){return false;}  if( !jQuery(\"#gform_7\")[0].checkValidity || jQuery(\"#gform_7\")[0].checkValidity()){window[\"gf_submitting_7\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_7\"]){return false;} if( !jQuery(\"#gform_7\")[0].checkValidity || jQuery(\"#gform_7\")[0].checkValidity()){window[\"gf_submitting_7\"]=true;}  jQuery(\"#gform_7\").trigger(\"submit\",[true]); 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