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Cort Driver Initials: Truck Driver Initials: Pick-up Address: DATE Destination Address: START MILEAGE DATE IN ENDING MILEAGE DOWN TIME HRS. TOTAL MILES OVER NIGHT YES NO YES NO YES NO REASON FOR DELAY TOTAL MILES: TOTAL OVER NIGHTS: DOWN TIME HRS.: TOLLS: TOTAL NO GO S: X DATE: (ESCORT DRIVER S SIGNITURE) X DATE: (TRUCK DRIVER S SIGNITURE) *Escort & Load Driver are responsible for confirming the dimensions of the load and that ALL permit requirements/conditions are.
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