         
|
|
Download - OP-1.PDF To view PDF files you must have Acrobat Reader, download the PDF File Reader
--------------------------------------------------------------------------------
APPLICANT'S LEGAL BUSINESS NAME and DOING BUSINESS AS NAME. The applicant name should be your full legal business name -- the name on the incorporation certificate, partnership agreement, tax records, etc. If you use a trade name that differs from your official business name, indicate this under "Doing Business As Name." Example: If you are John Jones, doing business as Quick Way Trucking, enter "John Jones" under APPLICANT'S LEGAL BUSINESS NAME and "Quick Way Trucking" under DOING BUSINESS AS NAME. Because the FMCSA uses computers to retain information about licensed carriers, it is important to spell, space, and punctuate any name the same way each time you write it. Example: John Jones Trucking Co., Inc.; J. Jones Trucking Co., Inc.; and John Jones Trucking are considered three separate companies. BUSINESS ADDRESS/MAILING ADDRESS. The business address is the physical location of the business. Example: 756 Bounty Street; 15433 State Highway 23. If applicant receives mail at an address different from the business location, also provide the mailing address. Example: P.O. Box 3721. NOTE: To receive pertinent FMCSA notices and to ensure that insurance documents filed on applicant's behalf are accepted, notify the FMCSA, in writing, (400 Virginia Avenue, S.W., Suite 600 Washington, DC 20024) if the business or mailing address changes. REPRESENTATIVE. If someone other than the applicant is preparing this form, provide the representative's name, title, position, or relationship to the applicant, address, and telephone and FAX numbers. Applicant's representative will be the contact person if there are questions concerning this application. U.S. DOT NUMBER.Applicants subject to the Federal Motor Carrier Safety Regulations are required to register with the U.S. Department of Transportation (U.S. DOT) before initiating service. Motor carriers that already have been issued a U.S. DOT registration number, should provide it; applicants that have not registered with U.S. DOT should refer to the U.S. DOT information sources under the "Additional Assistance" part of these Instructions. FORM OF BUSINESS. A business
is either a corporation, sole proprietorship, or a partnership.
If the business is a sole proprietorship, provide the name of the
individual who is the owner. In this situation, the owner is the
authority applicant. If the business is a partnership, provide the
name of each partner. --------------------------------------------------------------------------------
TYPE OF AUTHORITY.
Check the appropriate box(es) for the type(s) of authority you are
requesting. Note: A separate filing fee is required for each type
of authority requested. See "Fee Policy" in the application
form. (A broker arranges for the transportation where the actual
movement will be performed by licensed motor carriers. Brokers assume
no responsibility for the property being transported.) INSURANCE INFORMATION. Check the appropriate box(es) to describe the type of business you will be conducting. If you operate vehicles with a gross vehicle weight rating exceeding 10,000 pounds and haul only non-hazardous materials, you are required to maintain $750,000 minimum liability coverage for the protection of the public. Hazardous materials referred to in the insurance regulations at 49 CFR 387.303(b)(2)(c) require $1 million minimum liability coverage; those at 49 CFR 387.303(b)(2)(b) require $5 million minimum liability coverage. If you operate only vehicles with a gross vehicle weight rating under 10,000 pounds, you must maintain $300,000 minimum liability coverage. If you operate only such vehicles but will be transporting any quantity of Class A or B explosives, any quantity of poison gas (Poison A), or highway route controlled quantity of radioactive materials, you must maintain $5 million minimum liability coverage. Brokers of general freight and household goods must have on file with the FMCSA a surety bond or trust fund agreement in the amount of $10,000. Minimum levels of cargo insurance must be maintained by all motor property common carriers: $5,000 for loss of or damage to property carried on any one motor vehicle and $10,000 for loss of or damage to property occurring at any one time and place. Appropriate insurance forms must be filed within 90 days after the date notice of your application is published in the FMCSA Register: Form BMC-91 or BMC-91X for bodily injury and property damage, Form BMC-34 for cargo liability, Form BMC-84 for broker surety bond, and Form BMC-85 for broker trust fund agreement. The FMCSA does not furnish copies of
insurance forms. You must contact your insurance company to arrange
for the filing of all required insurance forms. --------------------------------------------------------------------------------
SAFETY CERTIFICATION. Applicants for motor carrier authority must complete the safety certification. You should check the "YES" response only if you can attest to the truth of the statements. The "Applicant's Oath" at the end of the application form applies to all certifications, and false certifications are subject to the penalties described in that oath. If you operate only vehicles with a gross vehicle weight rating under 10,000 pounds and will not transport hazardous materials, you are exempt from the U.S. DOT safety fitness regulations; however, you must certify that you are familiar with and will observe general operational safety fitness guidelines and applicable state and local laws relating to the safe operation of commercial motor vehicles. You must check only one of the boxes
in this section. --------------------------------------------------------------------------------
AFFILIATIONS. All applicants
must disclose pertinent information concerning affiliations, if
any, with other former ICC, now FMCSA licensed entities. --------------------------------------------------------------------------------
HOUSEHOLD GOODS CERTIFICATIONS. If you are applying for household goods common carrier, household goods contract carrier, or household goods broker authority, you must complete the appropriate certification concerning these specialized services in Section VI. If you are applying for household goods
contract carrier authority, you also must provide the information
concerning your operations in Section VII. --------------------------------------------------------------------------------
APPLICANT'S OATH. Applications
may be prepared by the applicant or an authorized representative.
In either case, the oath must be signed by the applicant. In the
case of companies, an authorized employee in the ownership structure
may sign. An individual with power of attorney to act on behalf
of the applicant may sign, provided that proof of the power of attorney
is submitted with the application. --------------------------------------------------------------------------------
--------------------------------------------------------------------------------
NOTE: RETAIN A COPY OF THE COMPLETED APPLICATION FORM AND ANY ATTACHMENTS FOR YOUR OWN RECORDS. Mailing addresses for applications: ALL DOCUMENTS WITH FEES ATTACHED:
-------------------------------------------------------------------------------- STATUS: AFTER YOUR APPLICATION
IS PROCESSED BY THE LICENSING & INSURANCE STAFF, YOU CAN CHECK
ITS STATUS ON THE INTERNET. APPLICATION, INSURANCE, AND PROCESS
AGENT INFORMATION APPEARS ON THE L&I WEBSITE AS SOON AS IT IS
MANUALLY ENTERED INTO THE DATA BASE OR FILED ELECTRONICALLY. The
website address is: http://li-public.fmcsa.dot.gov/
ADDITIONAL ASSISTANCE INFORMATION SOURCES Additional information on obtaining operating authority or monitoring the status of your applications is available through the FMCSA's Automated Response Capability (ARC) telephone system. After dialing (202) 358-7000, press 1, then request appropriate menu number indicated below. You may use the ARC 24 hours a day, 7 days a week to obtain information in the following areas: MENU NUMBER Information Requested
U. S. DEPARTMENT OF TRANSPORTATION INFORMATION SOURCES U.S. DOT Registration and Safety Ratings
or call: 800 832-5660 (Automated Response System) Note: The above number may also be contacted for information concerning a carrier's assigned safety rating. U.S. DOT Hazardous Materials Regulations
|
||
|
|