FMCSA Random Program for Companies with 40+ Drivers

Package includes:

Initial fee includes one time set up fee of $100.00
Stand Alone Company Managed Random Pool at $220/year
Audit assistance, MIS reporting, and ongoing consultation
Designated Employer Representative Recorded Training – including Quiz and
Certificate of Completion
Drug Free workplace Poster and Vehicle Stickers
Nationwide Drug & Alcohol Testing
Electronic Chain of Custody (nationwide) or Paper CCF available
Electronic reporting and storage of results.
Company pays only for tests with completed specimen collection

Price: $320.00(each)

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Company Details

Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
DOT # (If Applicable)
If FMCSA Regulated, Enter your DOT #; Otherwise, leave blank.

CDL Number*
State of Issue*
Social Security or ID Number*
Zip Code for the Collection site*
Date of Birth*
DD dash MM dash YYYY
Designated Employer Representative (DER)
Designated Employer Representative (DER)
Phone*
Email*
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Product Name

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