Please enable JavaScript in your browser to complete this form.Company Name * Electronic Email Company Email *New Account Terms & Conditions Company agrees to enlist the Consortium Third Party Administration (C/TPA) services provided by BRAVO Compliance LLC and 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 agreement which renews initial term of this agreement and automatically renews on 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. Owner/Operator or Designated Employer Representative (DER) is responsible for providing updated participant rosters on a quarterly basis upon request. Failure to provide updated rosters can result in additional fees or removal from the consortium. Selection reports will be sent each quarter providing evidence of the company’s active enrollment in the BRAVO Consortium. It is the responsibility of the Owner/Operator or DER to receive and respond to all communications by Carolina Testing or BRAVO Compliance and update any changes to telephone, address 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 or BRAVO Compliance 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 and BRAVO Compliance harmless for any violations, fines or disciplinary action issued to the Company by the Department of Transportation or its agencies. BILLING TERMS & CONDITIONS: All invoices are generated and emailed on a monthly basis for services provided.Payment via company check, ACH or credit card is accepted (credit card surcharge of 3% applies).Terms for payment are Net 30 unless other terms have been agreed to in writing. Accounts 15 days past due date are subject to a $25.00 late fee plus interest of 18% per annum charged monthly. Accounts 60 days past due date are subject to suspension of services until paid in full. Accounts 90 days past due will be closed and referred for collection. Customer is responsible for all legal and collection fees added to the account in addition to ongoing finance charges. Disputes must be made in writing (email preferred) and within 30 days of receipt of the original invoice. If the customer requests to submit invoices in any manner other than direct email, they will incur an administrative fee of $25 per invoice. I, the undersigned representative of the company, agree to these terms and conditions as presented. Electronic Signature *Date *Submit