Form Op-1 - Application For Motor Property Carrier And Broker Authority - U.s. Department Of Transportation Page 11
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17NOTE (continued):
•
Brokers of Property and Brokers of Household Goods require one of the following in the amount
of $10,000:
o Broker Surety Bond (Form BMC-84) must be filed by an insurance company.
o Broker Trust Fund Agreement (Form BMC-85) must be filed by a financial institution.
This form is available at
or by request from the FMCSA
Insurance Team, Commercial Enforcement Compliance Division, at 1-866-637- 0635 (toll-free)
or 202-385-2423.
•
An insurance company must file the appropriate insurance form(s) on behalf of the applicant within
90 days of the date the application for Operating Authority was published in the FMCSA Register.
Call FMCSA toll-free at 1-866-637-0635 to request information about insurance providers.
•
For more information about FMCSA’s insurance regulations, see
“Step 4 -
Insurance” under
“What
Are the Steps in Getting Operating
Authority?” (Topic IV) in this packet.
SECTION IV – Safety Certification
Only applicants that will operate commercial motor vehicles must complete this section. Select only
one response.
Applicants that will only operate vehicles with a GVWR under 10,000 pounds and will not transport
hazardous materials, are exempt from the Federal Motor Carrier Safety Regulations. Skip to the paragraph
“EXEMPT APPLICANTS,” read the corresponding statement, and select the “YES” response in this part only
if the applicant attests that the entire statement is true.
All other applicants that will operate vehicles with a GVWR of more than 10,000 pounds must read the
statements under “APPLICANTS SUBJECT TO FEDERAL MOTOR CARRIER SAFETY REGULATIONS.”
These statements describe the activities that Motor Carriers and U.S.-based Enterprise Carriers must follow
in order to comply with the FMCSRs. Select the “YES” response in this part only if the applicant attests that
all statements are true.
SECTION V – Affiliations
Only applicants with any relationship within the past 3 years to any business entity
regulated/licensed by the FMCSA, ICC, FHWA, or OMCS must complete this section.
Examples of an affiliation or relationship include, but are not limited to, owning another company (even a
percentage of stock), providing a loan to another company, managing another company, or having a family
relationship with an owner or manager of another company.
Disclose any past or current relationship within the last 3 years by providing the following:
•
Description of affiliation or relationship
•
Name of the company
•
MC/FF Number
•
USDOT Number
•
Latest DOT safety rating (for more information, see “
Information Sources
” (Topic VI) in this packet)
Instructions for Form OP-1 (Revised 8/13/2007)
Page 11
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