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Independent Contractor Information

Type of Contract Classification
Title
Suffix
Address
Birthday (Must be 21 or older for Network Eligibility)
Month
Day
Year

Experience

Company 1

Company 1 Address
Start Date
Month
Day
Year
End Date
Month
Day
Year

Company 2

Company 2 Address
Type- Document

Credentials

Do you have any of these Certifications? (Check all that apply)

Vehicle

Type- Image or Document
Do you plan to utilize employees, drivers, or subcontractors to fulfill contracted routes?
Main Vehicle Type

All vehicle types are considered; routing assignments are based on vehicle capacity.

Type- Image or Document
Type- Image, Document

Questionnaire

Available Delivery Equipment (Check all that apply)
Do you carry a smartphone?
Yes- Apple
Yes- Android
No
Do you carry a portable car charger?
Yes
No
No, but I'm willing to get one.
Do you have an insulated transport cooler and ice packs for temperature- sensitive specimens?
Yes
No
No, but I'm willing to get them.
Are you comfortable transporting properly packaged, sealed medical specimens and laboratory samples?
Yes
No
Maybe
General Availability (Select all that apply)

By clicking Join our Network of Contractors, you acknowledge and agree that any potential engagement with ER Courier would be strictly as an independent contractor, and nothing in this application process creates an employer-employee relationship. Furthermore, entering this network or completing this application does not guarantee the offer of any routes, assignments, or contracted work.


You expressly acknowledge that as an independent contractor, you operate an independent business entity. Under this application and any resulting agreements, you are solely responsible for providing your own vehicle, tools, and equipment. You assume full financial and legal responsibility for all operational costs, including but not limited to vehicle maintenance, fuel, registration, taxes, and maintaining valid auto insurance that complies with California business requirements. You agree that ER Courier holds zero liability for any traffic violations, vehicular wear-and-tear, or accidents incurred while fulfilling contracted routes.


You acknowledge and agree that strict compliance with all applicable local, state, and federal regulations—including but not limited to OSHA standards, Department of Transportation (DOT) requirements when applicable, Bloodborne Pathogen Certification, and the Health Insurance Portability and Accountability Act (HIPAA) governing patient privacy and data security—is a material condition of network eligibility. You further agree that if you utilize any subcontractors, employees, or personnel to fulfill contracted routes, you assume full responsibility for ensuring all such personnel are fully certified in HIPAA and Bloodborne Pathogen standards. Valid proof of these certifications for any utilized personnel must be submitted to ER Courier prior to handling any medical cargo. Any failure by you or your personnel to maintain these regulatory standards, any breach of Protected Health Information (PHI), or any failure to provide verification of compliance constitutes an immediate material breach of contract, resulting in the automatic revocation of network access, termination of vendor agreements for cause, and full indemnification of ER Courier for any resulting regulatory fines.


In the event of any dispute, claim, or controversy arising out of or relating to this agreement, network access, or an alleged material breach, both parties agree to resolve the matter exclusively through private, good-faith mediation prior to initiating formal legal proceedings. Each party shall be solely responsible for bearing its own legal fees, costs, and expenses incurred during the mediation process. Should formal dispute resolution proceedings be pursued past mediation concerning a contractual breach or termination, the prevailing party in such action shall be entitled to recover its reasonable attorney's fees, court costs, and legal expenses from the non-prevailing party.


By providing your phone number and clicking Join our Network of Contractors, you expressly consent to receive communications, including text messages, phone calls, and automated notifications regarding route availability and onboarding updates from ER Courier at the number provided. Consent is not a condition of service; however, you acknowledge that route availability is broadcast primarily through automated text notifications, and opting out of these communications will limit your ability to receive real-time notices of available contracted work.

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