Form Op-1 - Application For Motor Property Carrier And Broker Authority Page 14

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FORM OP-1 Revised 01/10/2017

OMB No.: 2126-0016 Expiration: 01/31/2020

Section

HOUSEHOLD GOODS

CERTIFICATIONS

33. HOUSEHOLD GOODS MOTOR COMMON CARRIER APPLICANTS (including United States-based Enterprise Carriers of International

Household Goods) MUST CERTIFY AS FOLLOWS:

Applicant is fit, willing, and able to provide the specialized services necessary to transport household goods. This assessment of fitness

includes applicant’s general familiarity with former ICC, FHWA, or OMCS, now FMCSA regulations for household goods movements

and also requires an assurance that applicant has or is willing to acquire the protective equipment and trained operators necessary to

perform household goods movements and that applicant will offer arbitration as a means of settling loss and damage disputes on

collect-on-delivery shipments. The proposed operations will serve a useful public purpose responsive to a public demand or need.

YES

34. HOUSEHOLD GOODS MOTOR CONTRACT CARRIER APPLICANTS (including United States-based Enterprise Carriers of International

Household Goods) MUST CERTIFY AS FOLLOWS:

Applicant is fit, willing, and able to provide the specialized services necessary to transport household goods. This assessment of

fitness includes applicant’s general familiarity with former ICC, FHWA, or OMCS, now FMCSA regulations for household goods

movements and also requires an assurance that applicant has or is willing to acquire the protective equipment and trained operators

necessary to perform household goods movements and that applicant will offer arbitration as a means of settling loss and damage

disputes on collect-on-delivery shipments. The proposed service will be consistent with the public interest and the transportation

policy of

49 USC

13101.

YES

35. HOUSEHOLD GOODS BROKER APPLICANTS MUST CERTIFY AS FOLLOWS:

Applicant is fit, willing, and able to provide household goods brokerage operations and to comply with all pertinent statutory and

regulatory requirements. The involved services will be consistent with the public interest and the transportation policy of

49 USC

13101.

YES

Applicant may attach a supporting statement to this application to provide additional information about

ATTACH FILE

any of the above certifications. This evidence is optional.

Section

SCOPE OF OPERATING

AUTHORITY

ONLY APPLICANTS REQUESTING OPERATING AUTHORITY AS A MOTOR CONTRACT CARRIER OF HOUSEHOLD GOODS

MUST COMPLETE THIS SECTION; CHECK ALL BOXES THAT APPLY.

36. Contracting shippers have one or more of the distinct needs delineated in

Interstate Van Lines, Inc., Extension — Household Goods, 5

I.C.C.2d 168

(1988). Describe briefly the distinct need(s):

37. Contracts provide for assignment of one or more vehicles for the exclusive use of each shipper in the manner specified in

Interstate Van

Lines, Inc., Extension — Household Goods, 5 I.C.C.2d 168

(1988).

NOTE: All motor carriers must comply with all pertinent Federal, State, local and tribal statutory and regulatory requirements when operating within the

United States. Such requirements include, but are not limited to, all applicable statutory and regulatory requirements administered by the U.S. Department of

Labor, or by a State agency operating a plan pursuant to Section 18 of the Occupational Safety and Health Act of 1970 (“OSHA State plan agency”). Such re-

quirements also include all applicable statutory and regulatory environmental standards and requirements administered by the U.S. Environmental Protection

Agency or a State, local or tribal environmental protection agency. Compliance with these statutory and regulatory requirements may require motor carriers

and/or individual operators to produce documents for review and inspection for the purpose of determining compliance with such statutes and regulations.

FORM OP-1 • Page 4 of 6