Contractor OQ Form

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Contractor Signup

Please select one option below: *

My company is brand new to Veriforce (no prior account)
My company is a former Veriforce customer and needs to sign up again
My company has ONLY used the Veriforce Drug & Alcohol Compliance service and needs to subscribe to Operator Qualification (OQ)
My company is a TPA (Third-Party Administrator) of drug & alcohol programs and needs to establish a new Veriforce account

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Billing Contact

This is the individual who will be responsible for your company’s payment of Veriforce invoices. All Veriforce invoices will be delivered by email to your billing contact.

Will you be your company's Billing Contact? *

Yes
No

VeriSource Account Administrator/General Contact

This is the individual who will manage your company’s employees’ access to our web-based VeriSource software. Once your signup is processed, Veriforce will email your company’s initial VeriSource login credentials to your account administrator.

Will you be your company’s Account Administrator/General Contact? *

Yes
No

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Please select one option below: *

Initial Setup Fee

This is the one-time setup fee for your company’s Veriforce account, which covers your company’s setup in our VeriSource software and initial support costs. Only applies if your company meets the specific criteria described below.

Initial Setup Fee: $250 (one-time)

Applies if your company is signing up for Operator Qualification (OQ) Compliance or Drug & Alcohol (D&A) Compliance for the first time
Applies if your company formerly had a Veriforce account that was cancelled
Applies if your company signed up for Drug & Alcohol Compliance prior to 1/1/21 and is now adding other software/services
Does not apply to Third-Party Administrators ONLY signing up to administer Drug & Alcohol Compliance on behalf of a contractor company

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If TPA registration ONLY, you may skip this step.

Contractor DOT Bundle: Includes Operator Qualification (OQ), DOT Drug & Alcohol Compliance, Training Management, and Pipeline Skills 101 CBT Library

Sign up for this service required by my hiring client

Veriforce provides DOT solutions in one complete bundle so you have the solutions you need to manage QIs and comply with DOT regulations. In addition to the initial setup fee and your company's QI fees, the tier structure below will determine your Annual DOT Bundle Price. Contractors who purchase Drug and Alcohol Compliance ONLY will be placed in the 0: $100 price tier. We reserve the right to adjust your tier based on your company's actual number of QIs. These fees do not apply to Third Party Administrators.

What's Included in the Contractor DOT Bundle

Contractor OQ
A key component of our uniquely comprehensive OQ compliance solution, enabling contractors to comply with regulatory and hiring clients OQ qualifications to help get you ready to work.

Training Management
Benefit from an integrated solution that enables you to more efficiently manage training associated with OQ, drug and alcohol, and/or safety compliance programs, technical or new hire training programs, and more.

DOT D&A
Efficiently meet the asks from hiring clients to satisfy regulatory requirements and get ready to work by providing your D&A information once, and sharing it with relevant hiring clients.

Pipeline Skills 101
A collection of online training courses specifically designed to help workers who are new to the pipeline industry quickly get up to speed on key pipeline operations concepts. The Pipeline Skills 101 CBT Library includes 30 courses that cover a range of critical learning areas for new pipeline workers.

Number of QIs	Annual DOT Bundle Price
0	$100
1-4	$200
5-9	$300
10-19	$400
20-24	$500
25-49	$600
50-99	$700
100-249	$800
250-499	$900
500-999	$1000
1000-2499	$2000
2500+	$3000

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If D&A or TPA registration ONLY, you may skip this step.

	Subscription Option	Pay-As-You-Go Option
How It Works	Contractor company decides the number of QIs it wants to pre-purchase for its subscription period QIs are good for the duration of the contractor’s subscription period (regardless of when activated throughout the 12-month period)	Contractor company pays for each QI as he/she is activated during the contractor’s subscription period QIs are good for the duration of the contractor’s subscription period (regardless of when activated throughout the 12-month period)
Fee per QI	$150 per QI per year	$195 per QI per year
Fee for Any QI Overages	$195 per extra QI (applies only if contractor company needs to purchase extra QIs during their subscription period beyond those pre-purchased)	n/a
When OQ Billing Occurs	Each year at January 1 renewal, contractor company will be billed for its full subscription amount based on the number of QIs the company decided to pre-purchase Any overages will be billed on a monthly basis as extra QIs are activated during the contractor’s subscription period	Beginning on its January 1 renewal date, contractor company will be billed on a monthly basis as QIs are activated

Please check below: *

I agree to pay the applicable fee(s) for service(s) required by my hiring client(s)

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Signup Summary & Subscription Terms

Please review the summary of the software and service(s) you’ve selected below, acknowledge the subscription terms, and then select Complete Signup. Veriforce will process your request and email your login credentials for VeriSource, our compliance management software, within 1 to 2 business days. Initially, your company will receive an invoice for the Initial Setup Fee, plus any annual subscription fees that are due now (if applicable). Sales tax will be added in accordance with federal, state, and local tax laws.

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I have read and agree to the Subscription Terms

Date *

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Contractor Signup Form

Sign up for an account with Veriforce and/or subscribe to new Veriforce software and services required by a hiring client.

Company Information

Billing Contact

VeriSource Account Administrator/General Contact

Initial Setup Fee

What's Included in the Contractor DOT Bundle

Signup Summary & Subscription Terms

Contact Veriforce Client Support at 800.426.1604