Form Op-1(Nna) - Application For U.s. Department Of Transportation (Usdot) Registration By Non-North America-Domiciled Motor Carriers Page 9

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OMB No.: 2126-0016 Expiration: 01/31/2020
FORM OP-1(NNA) Revised 01/10/2017
Section
4
INSURANCE INFORMATION
MOTOR PASSENGER CARRIER APPLICANTS
All motor passenger carriers operating in the United States, including non-North America-domiciled carriers, must maintain public
liability insurance. The amounts in parentheses represent the minimum amount of coverage required.
Applicant will use (check only one):
Any vehicle with a seating capacity of 16 passengers or more ($5,000,000)
Only vehicles with a seating capacity of 15 passengers or fewer ($1,500,000)
MOTOR PROPERTY CARRIER APPLICANTS (including Household Goods Carriers; check all that apply, if any)
NOTE: Refer to
Section 4
in the "Instructions for Form OP-1(NNA)" for information on cargo insurance filing requirements for
household goods carriers.
Applicant will operate vehicles having a gross vehicle weight rating (GVWR) of 10,000 pounds or more to transport:
Non-hazardous commodities ($750,000);
Hazardous materials referenced in the FMCSA insurance regulations at 49 CFR § 387.303(b)(2)(c) ($1,000,000);
Hazardous materials referenced in the FMCSA insurance regulations at 49 CFR § 387.303(b)(2)(b) ($5,000,000).
Applicant will operate only vehicles having a GVWR under 10,000 pounds to transport:
• any quantity of Division 1.1, 1.2 or 1.3 explosives; and/or
• any quantity of poison gas (Division 2.3, Hazard Zone A or Division 6.1, Packing Group 1, Hazard Zone A materials); and/or
• highway route controlled quantity of radioactive materials ($5,000,000).
Does the applicant presently hold public liability insurance?
Yes
No
If the applicant does hold such insurance, please provide the information below:
INSURANCE COMPANY
POLICY NUMBER
MAXIMUM INSURANCE AMOUNT
STREET ADDRESS/ROUTE NUMBER
STATE/PROVINCE
COUNTRY
ZIP CODE
DATE ISSUED
INSURANCE EFFECTIVE DATE
INSURANCE EXPIRATION DATE
FORM OP-1(NNA) Instructions • Page 5 of 16

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