EX-99.5 10 d571711dex995.htm EX-99.5 EX-99.5

Exhibit 99.5

ROADRUNNER TRANSPORTATION SYSTEMS, INC.

FORM OF NOMINEE HOLDER CERTIFICATION

The undersigned, a broker, dealer, bank, or other nominee holder of rights (the “Subscription Rights”) to purchase shares of common stock, par value $0.01 per share (“Common Stock”), of Roadrunner Transportation Systems, Inc. (the “Company”), pursuant to the Rights Offering described and provided for in the prospectus dated                     , 2019 (the “Prospectus”), hereby certifies to the Company, American Stock Transfer & Trust Company, LLC, as Subscription Agent for the Rights Offering that the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the number of Subscription Rights specified below pursuant to the Basic Subscription Right (as defined in the Prospectus) and the Over-Subscription Right (as defined in the Prospectus).

 

    

Number of Shares of Common

Stock Owned on the

Record Date

  

Basic Subscription Rights Exercised

  

Over-Subscription Rights Exercised

1.

        

2.

        

3.

        

4.

        

5.

        

6.

        

7.

        

8.

        

9.

        

10.

        

 

 

Name of Broker, Dealer, Bank or Other Nominee

 

By:  

 

Name:  
Title:  

Provide the following information, if applicable:

Depository Trust Company (“DTC”) Participant Number:                 

 

 

 

Participant

 

By:  

 

Name:  
Title:  

DTC Basic Subscription Confirmation Number(s):