BROWNSVILLE PEDICAB Pilot Application
BROWNSVILLE PEDICAB operates a pedicab business, primarily in the downtown area--Mitte Cultural District. By completion of this application, you are indicating that you desire to contract with Brownsville Pedicab LLC as an independent contractor. You additionally agree, upon the acceptance of this application, to enter an agreement to ride with Brownsville Pedicab LLC.
NOTE: Brownsville Pedicab LLC does not hire employees for its business operations. As an
independent contractor, you will be solely responsible for the payment of taxes and for the
provision of any insurance, health and/or death benefits. Please fill out the following form.
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Name *
first and last name
Phone number *
Email *
Address *
Driver’s License Information *
DL Number, State, Expiration Date __ __/__ __/__ __
Applicant Background *
Have you ever been convicted (including a plea of guilty or no contest) of a crime (misdemeanor or felony) by a court, including a military court?
If so, list charge date.
Are there felony charges pending against you? *
Employment History *
Have you ever been employed by, contracted with, or applied for a position with another pedicab company?
If yes, who?
Briefly tell us about your last three jobs: employer, phone number, length of employment. *
Have you ever been discharged or suspended from employment? *
If yes, explain.
Please list two (non-relative) references: name, occupation/relationship, years known, reference phone number. *
BROWNSVILLE PEDICAB APPLICANT WAIVER AND AGREEMENT                                               PLEASE READ CAREFULLY:  In return for being considered as an Independent Contractor for BROWNSVILLE PEDICAB LLC, I agree as follows:  I affirm that the facts set forth above are true and complete to the best of my knowledge. False statements or omissions on this application may result in a refusal to contract, revocation of an offer to contract, or termination of the contractual relationship between myself and Brownsville Pedicab LLC whenever they may become known. I authorize Brownsville Pedicab LLC or its representatives to investigate thoroughly my work and professional history and verify all data provided, and I withhold Brownsville Pedicab LLC from any liability which might arise from such an investigation. I further release any former or existing contractor/employer from any obligation to provide me with written notification of any information disclosed. I understand that this may include a record of disciplinary action assessed by the contractor/employer. I understand that any contractual relationship arising out of this application is contingent upon the results of this investigation. BROWNSVILLE PEDICAB LLC WILL USE THE INFORMATION YOU PROVIDE IN MAKING ITS DECISION WHETHER TO CONTRACT YOU AS AN INDEPENDENT DRIVER FOR HIRE. THE DECISION TO CONTRACT YOUR SERVICES WILL BE PARTIALLY BASED ON TRAFFIC LIABILITY CONSIDERATIONS AND PERSONAL AND PUBLIC HEALTH AND SAFETY CONCERNS. IF WE DECIDE TO CONTRACT YOU, A SEPARATE WRITTEN INDEPENDENT CONTRACTOR AGREEMENT WILL BE PROVIDED. INDEPENDENT CONTRACT DRIVERS ARE NOT EMPLOYEES OF BROWNSVILLE PEDICAB LLC. *
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