Zip-Dash21+ Local Delivery · Palm Beach County

Driver Onboarding Application

Independent Contractor Agreement & Background Authorization

Date
Application #
IMPORTANT: ZipDash Delivery operates exclusively in Palm Beach County, FL and delivers age-restricted products (21+). All drivers must be 21 or older and are responsible for verifying customer age at delivery. Drivers are engaged as independent contractors, not employees.

1. Personal Information

Legal First Name
Legal Last Name
Date of Birth (MM/DD/YYYY)
Age
Social Security # (last 4 for ID)
Home Address (Street, City, State, ZIP)
Primary Phone Number
Email Address
Emergency Contact — Full Name
Emergency Contact — Phone

2. Florida Driver's License

License Number
License Class (A / B / C / D / E)
Expiration Date
Issuing State
License Restrictions (if any)
Has your license ever been suspended or revoked? Yes    No
Do you have any DUI / DWI convictions in the last 5 years? Yes    No
Do you have any reckless driving convictions in the last 3 years? Yes    No

3. Vehicle Information

Year
Make
Model
Color
License Plate #
Plate State
VIN (Vehicle Identification Number)
Vehicle Registration Expiration
Is the vehicle registered in your name? Yes    No
Is the vehicle currently in good mechanical condition? Yes    No

4. Auto Insurance

Insurance Provider / Company
Policy Number
Policy Holder Name (if not you)
Policy Expiration Date
Bodily Injury Liability Limits
Property Damage Liability Limits
Does your policy cover commercial/gig delivery use? Yes    No

5. Delivery & Driving Experience

Current or recent gig platforms (check all that apply):

Uber / UberEats
DoorDash
Lyft
Instacart
Amazon Flex
Gopuff
GrubHub
Other: _______________
Total years of delivery driving experience
Approx. deliveries completed (lifetime)
Have you ever had a delivery account deactivated or suspended? Yes    No
If yes, explain briefly:

6. Availability

ZipDash operates Mon–Sun, 10 AM – 10 PM. Check your typical availability:

Monday
From
To
Not Available
Tuesday
From
To
Not Available
Wednesday
From
To
Not Available
Thursday
From
To
Not Available
Friday
From
To
Not Available
Saturday
From
To
Not Available
Sunday
From
To
Not Available
Estimated hours available per week
Earliest you can start (MM/DD/YYYY)

7. Smartphone & Technology

Phone Type (iPhone / Android)
Phone Model
Telegram Username (if any)
Are you comfortable receiving delivery instructions via Telegram? Yes    No
Do you have a smartphone data plan (not Wi-Fi only)? Yes    No

8. Background Check Authorization

I hereby authorize ZipDash Delivery (Day One Legacy Group LLC) to obtain a consumer report and/or investigative consumer report about me for employment/contractor screening purposes. I understand this report may include information about my driving record, criminal history, and identity verification. I understand that I have the right to request the nature and scope of any investigation, and to request a copy of any report obtained.

Full Legal Name (print)
Date of Birth
Signature
Date

9. Independent Contractor Acknowledgment

I understand and agree that:

  • I am engaged as an independent contractor, not an employee of ZipDash Delivery or Day One Legacy Group LLC.
  • I am responsible for my own taxes, insurance, and expenses.
  • I may work for other platforms and am not required to accept any specific delivery.
  • I am responsible for verifying the age (21+) of every customer before handing over any delivery. Failure to do so may result in immediate removal from the platform.
  • I will maintain a valid Florida driver's license, current vehicle registration, and active auto insurance at all times while delivering for ZipDash.
  • I will handle all products with care and ensure deliveries are made to the correct address and recipient.
  • ZipDash reserves the right to terminate this contractor relationship at any time for any reason.

By signing below, I confirm I have read, understood, and agree to all of the above:

Driver Signature
Date
Printed Full Name

— For Office Use Only —

Reviewed By
Date Reviewed
Background Check Status
Background Check Date
Reference / Report #
License verified
Insurance verified
Vehicle inspected
Telegram added
Onboarding complete
ZipDash Driver ID assigned
Start Date
Notes:

ZipDash Delivery · Day One Legacy Group LLC · Palm Beach County, FL · zipdash.co · zipdashdelivery@gmail.com · (561) 402-4292