Panther II Transportation, Inc.

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Fleet Compliance Binder Revised March 2022

Transcript of Panther II Transportation, Inc.

Fleet Compliance Binder Revised March 2022

Panther II Transportation, Inc. D/B/A Panther Premium Logistics

USDOT Number: 500737

MC Number: 257496

Fleet Compliance Binder

Electronic Logging Device (ELD)

Section 1: ELD Reference Material

Samsara Required ELD In-Cab Materials 1.1

Samsara DOT Instruction Sheet 1.2

License, Permits, and Certificates

Section 2: General Certificate of Liability Insurance 2.1

Vehicle Registration 2.2

Annual DOT Inspection 2.3

Independent Contractor Operating Agreement (ICOA) 2.4

International Fuel Tax Agreement (IFTA) License 2.5

Pennsylvania Spotted Lanternfly Permit 2.6

Unified Carrier Registration (UCR) 2.7

Section 3: Hazardous Materials Alliance for Uniform Hazmat Transportation Procedures 3.1

Hazardous Materials Safety Permit (HMSP) 3.2

Hazardous Materials Certificate of Registration 3.3

Hazardous Materials Transportation License (California) 3.4

Hazardous Materials Permit (Colorado) 3.5

New York Thruway Authority Explosive Permit 3.6

Section 4: Canada

British Columbia Financial Responsibility Certificate 4.1

Canada Border Services Agency Customs Bond 4.2

Ontario | Commercial Vehicle Operator’s Registration (CVOR) Certificate 4.3

Quebec | Register Identification Number (RIN) 4.4

Forms and Documents

Section 5: Forms and Documents

Vehicle Maintenance Record 5.1

Safety Compliance and Risk Management Requests 5.2

Required ELD In-Cab Materials ELD Mandate: Required In-vehicle Information

In 49 CFR 395.22, the ELD mandate requires that every ELD-equipped vehicle must have documents describing how a driver can operate the device, including:

• Eight (8) days of blank paper logs in the event of an ELD malfunction

• User Manual for the ELD

• Driver Instruction Sheet describing:

• How to operate the ELD in the event of an inspection; and

• ELD "malfunction reporting requirements" and "record keeping procedures during ELD malfunctions" Samsara has the User Manual and Driver Instruction Sheet available in the Samsara Driver App. Eight (8) days of blank logs will be provided by Panther.

Accessing ELD In-Cab Materials from the Driver App:

Start by logging into the Driver App. From there, select Settings > Help > ELD In-Cab Materials > Driver App Manual or Transfer Page Instruction Sheet to view.

In Summary

The ELD mandate requires that a user manual and driver instruction sheet are available in the vehicle's cab.

• The driver instruction sheet is required to be within reach of the driver and is located in the front of your permit binder. Make sure you locate and understand the instructions.

• The FMCSA has also clarified that the manuals may be made available to drivers in the vehicle in electronic form. Having these documents available in the driver app are fully compliant with FMCSA.

VERSION 06.20

1. From the Roadside Inspection screen, tap ‘Transfer’.

2. Send official logs via Wireless Web Services or E-mail to DOT.

1. Open the Samsara Driver App and tap the HoS icon.

2. Tap the Roadside icon.

INSPECTING HOURS OF SERVICE LOGS

TRANSFERRING HOURS OF SERVICE LOGS

Manufacturer’s Certification of ELD Registration and Compliance

This document, provided by Samsara, certifies

that the Samsara ELD is a registered ELD with

the Federal Motor Carrier Safety Administration

(FMCSA) and is compliant with FMCSA ELD

technical regulations specified in 49 CFR § 395.

Statement of Compliance: Electronic Recording Device

This document certifies that the Samsara

ELD can be used to meet requirements for

Electronic Recording Devices in Canada

SOR/2005-313 Section 83.

3. Enter officer-provided Data File. 4. Tap ‘Send’ to send logs to DOT.

The Samsara ELD is a registered ELD with the Federal Motor Carrier Safety Administration (FMCSA). It plugs into the diagnostic port in a vehicle and integrally synchronizes with the vehicle engine. Drivers are not able to edit automatically-recorded driving time.

The Samsara Driver App allows drivers to view and interact with their logs via a smartphone or tablet. The app’s DOT Inspection Mode enables officials to review and transfer hours of service logs.

DOT Instruction SheetSAMSARA DRIVER APP

This instruction sheet is required to be kept on board and available to present

during inspections per FMCSA 49 CFR § 395.22(h).

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

$

CERTIFICATE HOLDER

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE

OTHER:

LOCJECTPRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $DAMAGE TO RENTEDEACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

INSRLTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF(MM/DD/YYYY)

POLICY EXP(MM/DD/YYYY) LIMITS

PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

$

$

$

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe underDESCRIPTION OF OPERATIONS below

(Mandatory in NH)OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

OWNED SCHEDULED

HIRED NON-OWNEDAUTOS ONLY AUTOS

AUTOS ONLY AUTOS ONLY

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

$

$

$

$

INSDADDL

WVDSUBR

N / A

$

(Ea accident)

(Per accident)

The ACORD name and logo are registered marks of ACORD

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE(A/C, No, Ext):

PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

$$$$$

YX34QRTN

11/01/2022

EVIDENCE OF INSURANCE

1,000,000

250,000OC009CH211,000,000

503-943-6621 503-943-6622

Cargo

ACE American Insurance Company

Limit

1,000,000

43460

11/01/202211/01/2021

11/01/202211/01/2021

1,000,000

1,000,000

1,000,000

22667

A

Aspen American Insurance Company

XSL G72481367

11/01/2022

Excess of SIR

A

A

1,000,000

McGriff Insurance Services, Inc.1800 SW First Avenue, Suite 400Portland, OR 97201

Panther II Transportation, Inc. dba Panther Premium Logistics84 Medina Rd.Medina, OH 44256

10/21/2021

11/01/2021

WLR C68918741WCU C68918820 (Excess, StatutoryLimit)

1,000,000

Excess of SIR 0

1,000,000

XSA H25543245

B 11/01/2021

X

X

X

X

X

X

X

Page 1 of 1

Expires Dec 31, 2022

2022 UCR Registration is VALID!

Confirmation # 000-0295-6373

Generated: 12/13/2021 15:10 EST

Registered on: 12/13/2021 15:10 EST

Year: 2022

Paid:UCR Fee: $5835.00

Convenience Fee: $173.30Total: $6008.30

Bracket: 101 to 1000 vehicles [490 vehicle(s)]

USDOT #: 500737

Classifications: Motor Carrier

Legal Name: PANTHER II TRANSPORTATION INC

DBA: PANTHER PREMIUM LOGISTICS

Base State: US_OH

Principal:84 MEDINA ROAD MEDINA, OH 44256

US

Payor: PANTHER II TRANSPORTATION INC

*** Expires: 12/31/2022 ***

Alliance for Uniform Hazmat Transportation Procedures Uniform Program Credentials PANTHER II TRANSPORTATION INC 84 MEDINA ROAD MEDINA OH 44256 USDOT CENSUS #: 500737 MC #: 257496 EPA TRANSPORTER ID #: N/A PHMSA #: 060421550090DF

TELEPHONE NUMBER TO CALL IN CASE OF ACCIDENT OR EMERGENCY: 800-685-0657

UNIFORM PROGRAM #: UPM500737NV CERTIFIED BY: JOSHUA LARKIN REGISTRATION ISSUED: 01 OCTOBER 2021 REGISTRATION EXPIRATION: 30 SEPTEMBER 2022 ISSUING AGENCY: NEVADA HIGHWAY PATROL AGENCY TELEPHONE NUMBER: 775-684-4622

U.S. Department of Transportation

Federal Motor Carrier Safety 1200 New Jersey Ave., S.E.

Administration Washington, DC 20590

June 16, 2021

In reply refer to:

USDOT Number: 500737

MC Number: MC257496

DEAN FRYE DIRECTOR OF CLAIMS & SAFETY

PANTHER II TRANSPORTATION INC

PANTHER PREMIUM LOGISTICS

84 MEDINA ROAD

MEDINA, OH 44256

Dear DEAN FRYE:

HAZARDOUS MATERIALS SAFETY PERMIT HM Safety Permit ID: US-500737-OH-HMSP

Effective Date: June 16, 2021

The Hazardous Materials Safety Permit (HMSP) is verification of the motor carrier's permission

to engage in the transportation of hazardous materials listed in 49 CFR 385.403 by motor vehicle

in interstate, intrastate, or foreign commerce.

This HMSP will be effective beginning June 16, 2021 and remain effective through July 31, 2023 if

your company maintains compliance with the requirements pertaining to the safe and secure

movement of hazardous materials for the protection of the public (49 CFR 385 and other applicable

Federal Motor Carrier Safety Regulations and Hazardous Material Regulations). Failure to

maintain compliance will constitute sufficient grounds for suspension or revocation of this

authority.

Willful and persistent noncompliance with applicable safety fitness regulations as evidenced by a

Department of Transportation safety fitness rating less than "Satisfactory" or by other

indicators, could result in a proceeding requiring the holder of this permit to show cause as to

why this authority should not be suspended or revoked.

For questions regarding this document you may contact the FMCSA Hazardous Materials Division by

email at [email protected] or by phone at (202) 385-2400 or by fax at (202) 366-3621.

Sincerely,

Joseph P. DeLorenzo

Director, Office of Enforcement and Compliance

117-810-840 WB

Name and Mailing Address / Nom et adresse postale

PANTHER II TRANSPORTATION INC.O/A: 84 MEDINA ROAD MEDINA OH 44256

ATTENTION:ALLEN MOTTER

The CVOR Certificate or a copy must be surrendered on demand of a police officer. Not to do so is an offence.

Le certificat d'immatriculation IUVU ou une copie conforme de celui-ci doit être présente à l'agent de police qui en fait la demande. Quiconque ne respecte pas cette directive commet une infraction.

Detach here / Détachez ic

Issued pursuant to the Highway Traffic Act / Délivré en vertu du Code de Ia routeCommercial Vehicle Operator's Registration Certificate Certificat d'immatriculation d'utilisateur de véhicule utilitaireCommercial Vehicle Operator`s Registration No.N° d'immatriculation d'utilisateur de véhicule utilitaire

117-810-840

Name / Nom PANTHER II TRANSPORTATION INC.

O/A

Expiry Date / Date D'expiration

Y/A M D/J2023 03 08

This certificate or a copy must be carried in each commercial motor vehicle being operated under the Commercial Vehicle Operator's Registration.

For a replacement, of a CVOR Certificate complete and submit a Commercial Vehicle Operator's Registration (CVOR) ReplacementApplication form. For corrections or information changes, complete and submit a Commercial Motor Vehicle Operator's Registration (CVOR) Update Application form.Application forms are to be submitted to: Ministry of Transportation, Carrier Sanctions & Investigation Office, 301 St. Paul St., 3rd floor, St. Catharines. ON L2R 7R4.

Pour le remplacement d'un certificat d'immatriculation IUVU , remplir et soumettre le formulaire de demande de remplacement d'un utilisateur de véhicule utilitaire (IUVU ). Pour des corrections ou bien des demandes de mises à jour de l'information, remplir et soumettre un formulaire de demande de mise à jour d'un utilisateur de véhicule utilitaire (IUVU ).

Les formulaires de demandes doivent être soumis au: Ministère du transport, Bureau de la sécurité des transporteurs et de l'application des lois , 301 rue St. Paul, 3 èmeétage, St. Catharines On L2R 7R4

Revision 1/8/2019

First Quarter (Jan, Feb, Mar) - Due April 7

Second Quarter (Apr, May, Jun) - Due July 7

Third Quarter (Jul, Aug, Sept) - Due October 7

Fourth Quarter (Oct, Nov, Dec) - Due January 7

Date: ____________________ Truck Number: ____________________ Mileage: ____________________

Make|Model: ____________________ VIN Number (last 5): __________________

Owner Name: _______________________ Driver Name: ________________________ Owner|Driver Signature: _______________________________________

The “Vehicle Maintenance Record” must be completed with receipts attached and sent to Vehicle Maintenance every quarter by

the due dates above beginning from the contract date. Please enter the truck’s number at the top of each receipt submitted and

send to [email protected] or by fax to 330-239-3856. Any false reporting or failure to turn in this record will

result in the vehicle being placed out-of-service, and possible disqualification, until a Vehicle Maintenance Specialist receives the

record.

Check if a new truck with no maintenance to record

This record complies with the rules set forth in FMCSA regulations 49 CFR Part 396.3.

Date Repair Record (Nature of repair) Parts|Accessories

Date Tire Record Tire Size

Date Mileage Lube Oil Filter Trans Diff Battery Bearings

Revised July 24, 2019

Safety Compliance and Risk Management Requests

Change Requests

Driver Swaps

[email protected]

Truck Swaps

Owner Swaps

Phone Number Changes

Driver Information Changes

Truck Terminations

Driver Terminations

Fleet Maintenance

Annual DOT Inspections

[email protected]

Roadside Inspections and Citations

Quarterly Maintenance

CDL Renewals, Changes or Suspensions

Repair Receipts

Windshield Repair Receipts

Vehicle Maintenance

Registration Renewals

Medical

DOT Physicals / Renewals or Expirations

[email protected] Off-Site DOT Physicals and Drug Screens

DOT Medical Certification

Base Plates | Permits

Base Plates and Permits [email protected]

IFTA License and Decals

Fuel Tax [email protected]

Hours of Service | Logs

Hours of Service and Logs [email protected]

Claims | Risk | Insurance

Liability Claims [email protected]

Liability Claims and Insurance [email protected]

Occupational Accident Claims [email protected]

Passenger Policy [email protected]