Form Mcs-90 - Endorsement For Motor Carrier Policies Of Insurance For Public Liability Under Sections 29 And 30 Of The Motor Carrier Act Of 1980
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2FORM MCS-90 Revised 06/19/2014
OMB No.: 2126-0008 Expiration: 06/30/2016
A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current
valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information
is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and
reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal
Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590.
United States Department of Transportation
Federal Motor Carrier Safety Administration
Endorsement for Motor Carrier Policies of Insurance for Public Liability
under Sections 29 and 30 of the Motor Carrier Act of 1980
FORM MCS-90
Issued to
of
(Motor Carrier name)
(Motor Carrier state or province)
Dated at
on this
day of
,
Amending Policy Number:
Effective Date:
Name of Insurance Company:
Countersigned by:
(authorized company representative)
The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (check only one):
This insurance is primary and the company shall not be liable for amounts in excess of $
for each accident.
This insurance is excess and the company shall not be liable for amounts in excess of $
for each accident in excess of the
underlying limit of $
for each accident.
Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of
said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA ,
to verify that the policy is in force as of a particular date. The telephone number to call is:
.
Cancellation of this endorsement may be effected by the company of the insured by giving (1) thirty-five (35) days notice in writing to
the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice),
and (2) if the insured is subject to the FMCSA’s registration requirements under 49 U.S.C. 13901, by providing thirty (30) days notice to
the FMCSA (said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington, DC).
DEFINITIONS AS USED IN THIS ENDORSEMENT
Accident includes continuous or repeated exposure to conditions or
Environmental Restoration means restitution for the loss, damage,
which results in bodily injury, property damage, or environmental
or destruction of natural resources arising out of the accidental
damage which the insured neither expected nor intended.
discharge, dispersal, release or escape into or upon the land,
atmosphere, watercourse, or body of water, of any commodity
Motor Vehicle means a land vehicle, machine, truck, tractor, trailer,
transported by a motor carrier. This shall include the cost of removal
or semitrailer propelled or drawn by mechanical power and used on
and the cost of necessary measures taken to minimize or mitigate
a highway for transporting property, or any combination thereof.
damage to human health, the natural environment, fish, shellfish,
Bodily Injury means injury to the body, sickness, or disease to any
and wildlife.
person, including death resulting from any of these.
Public Liability means liability for bodily injury, property damage,
Property Damage means damage to or loss of use of tangible
and environmental restoration.
property.
(continued on next page)
FORM MCS-90 Page 1 of 2
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