Online Enrollment Form

  • $ 0
    Company agrees to enlist the Consortium Third Party Administration (C/TPA) services provided by Carolina Drug & Alcohol Testing Services, LLC (Carolina Testing) for random drug and alcohol testing management in accordance with 49 CFR Parts 40 and 382. This service agreement is an annual (January 1st to December 31st) agreement which is pro-rated in the initial term of this agreement and automatically renews on January 1 of each year until cancelled by Company in writing. Initial set up fee and annual fee are non-refundable. Agreement commences upon approval of the application and the issuance of a certificate of enrollment by C/TPA. All participants enrolled in the consortium must have a DOT pre-employment drug test with negative results on file with the company.

    DER is responsible for providing updated participant rosters to Carolina Testing on a quarterly basis upon request. Failure to provide updated rosters can result in additional fees or removal from the consortium. Carolina Testing will issue selection reports each quarter providing evidence of the company’s active enrollment in the BRAVO Consortium. It is the responsibility of the DER to receive and respond to all communications by Carolina Testing and update any changes to telephone or email as soon as possible. Failure to do so may result in removal from the consortium.

    Owner/operators are required to enroll in the Drug & Alcohol Clearinghouse and designate Carolina Drug & Alcohol Testing Service, LLC as their C/TPA. Failing to respond to notifications to test, refusing to test or testing positive for drugs or alcohol will result in being reported as required to the Drug & Alcohol Clearinghouse and immediate removal from the consortium.

    Any removal from the consortium other than by request of the company is reported to DOT.

    As the Designated Employer Representative or owner/operator of the Company, I hereby agree to the terms of this agreement and further acknowledge that random selections are required to be tested as selected within the timeframe allotted. I understand that Carolina Testing has the right to terminate our enrollment as a participant in the event of non-payment of services or failure to have testing completed as required.

    It is understood and agreed that it is ultimately the Company's responsibility to stay compliant with all DOT regulations and the Company agrees to hold Carolina Testing harmless for any violations, fines or disciplinary action issued to the Company by the Department of Transportation or its agencies.