H. C. Schmieding produce company, llc (“hcs”) Information Page Please fill out this page and all attached pages, and email or fax back to us along with your W9, coi, and mc authority letter

***ONCE WE PAY A FACTORING AGENT, WE CAN NOT PAY A
  _______________________________________________ 
DIFFERENT PARTY WITHOUT A WRITTEN RELEASE FROM 
_______________________________________________ 
THE EXISTING FACTORING AGENT, WITH A MINIMUM OF 
30 DAYS NOTICE*** 
 
Dispatcher Name: ______________________________________________ Email:
_________________________________ 
Phone Number: 
_____________________________________ext ______ Cell Number: _________________________________ 
 
24 Hr. Emergency Contact: ______________________________________ Email:
_________________________________ 
Phone Number: 
_____________________________________ext ______ Cell Number: _________________________________ 
Internal Insurance Contact: ______________________________________ Email:
_________________________________ 
Phone Number: 
_____________________________________ext ______ Cell Number: _________________________________ 
CUSTOMER REFERENCES: 
Company Name: 
Company Name: 
Company Name: 
Contact Name: 
Contact Name: 
Contact Name: 
Address: 
Address: 
Address: 
Phone: 
Phone: 
Phone: 
Performance comments: 
Performance comments: 
Performance comments: 
Bob
12/2/2022
Halol Transport LLC
471161207
9599 sparrow pc
873810
9599 sparrow pc 
2517820
Mason
OH
45040
Han
[e-mail] 
5139938582
Halol Transport LLC
9599 sparrow pc
OH
45040
Ned 
[e-mail]
5139930582
Alex 
5139938582
Nick
5136465609

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Carrier Payment and ACH Options 
As a Carrier for Schmieding Produce, we recognize and appreciate the important role you play in 
providing our customers with the highest quality transportation services available. As a company, 
Schmieding values the relationships we have with our carriers and strive to provide them with payment 
options that suits each carrier’s individual needs. For this reason, Schmieding has restructured our 
payment terms in hopes of remaining flexible and accommodating to each of our Carriers’ preferences.
We now offer several payment options, including options that will provide you with the ability to receive 
your money quickly and straight to your bank account.