permit book 5012
TRANSCRIPT
Permit Book: 5012
OHIO APPORTIONED REGISTRATION CAB CARD
Expiration Date : 09/30/2021Effective Date : 10/01/2020
REGISTRANT / OPERATOR NAME AND ADDRESS PLATE NUMBER VIN
1XKYDP9X1LJ347694
VEHICLE YEAR VEHICLE MAKE
UNIT NUMBER
ACCOUNT NUMBER FLEET NUMBER SUPPLEMENT NUMBER
UNLADEN WEIGHT
List the USDOT and Address of the Motor Carrier Responsible for Safety
OWNER/LESSOR NAME AND ADDRESS (IF APPLICABLE)
USDOT
PWK8396
2020 KW
5012
82182 001 000
17,500
CRITICAL SUPPLY SOLUTIONS, INC
7739 NEW CARLISLE PIKE
HUBER HEIGHTS OH 45424
CRITICAL SUPPLY SOLUTIONS INC
CRITICAL SUPPLY SOLUTIONS INC
11601 BISCAYNE BLVD
MIAMI BEACH FL 33181
001485385
ADDRESS
The vehicle described has been proportionally registered between the State of Ohio and the jurisdiction(s) shown below. Canadian
provinces are shown in kilograms, all other jurisdictions are shown in pounds.
80,000GROSS WEIGHT
APPLICATION NUMBER
215044HC
5720TAXING DISTRICT NUMBER
OHIO DEPARTMENT OF PUBLIC SAFETY
International Registration Plan (IRP)BUREAU OF MOTOR VEHICLES
09/29/2020Issue Date :
OH 80,000 AL 80,000 AR 80,000 AZ 80,000 CA 80,000 CO 80,000 CT 80,000
DC 80,000 DE 80,000 FL 80,000 GA 80,000 IA 80,000 ID 80,000 IL 80,000
IN 80,000 KS 80,000 KY 80,000 LA 80,000 MA 80,000 MD 80,000 ME 80,000
MI 80,000 MN 80,000 MO 80,000 MS 80,000 MT 80,000 NC 80,000 ND 80,000
NE 80,000 NH 80,000 NJ 80,000 NM 80,000 NV 80,000 NY 80,000 OK 80,000
OR 80,000 PA 80,000 RI 80,000 SC 80,000 SD 80,000 TN 80,000 TX 80,000
UT 80,000 VA 80,000 VT 80,000 WA 80,000 WI 80,000 WV 80,000 WY 80,000
AB 36,287 BC 36,287 MB 36,287 NB 36,287 NL 36,287 NS 36,287 ON 36,287
PE 36,287 QC 5 axles SK 36,287 ** ****** ** ****** ** ****** ** ******
This Ohio IRP Apportioned Registration Cab Card must be carried at all times in the vehicle to which it is issued in a legible readily
accessible physical or electronic format.
Must comply with all applicable federal and state safety regulations.
By authority of the Ohio Department of Public Safety, Bureau of Motor Vehicles, Ohio Revised Code (R.C) 4503.64, in accordance with International Registration
Plan (IRP) Article VI Section 610, this Ohio Apportioned Registration Cab Card (IRP Cab Card) hereby authorizes the named Registrant/Operator to operate the
described unit in all IRP jurisdictions as indicated by applicable weight, or axle count.
Failure to maintain the Motor Carrier Responsible for Safety associated with this vehicle at time of the Registrant/Operator's last application in good standing
(R.C.4503.642); or failing to submit required proof of payment and filing of the Heavy Highway Vehicle Use Tax (IRS Form 2290) as required annually by
registered weight (23 CFR § 669.3), will cause this registration to be suspended, and a request to local law enforcement to confiscate the Ohio Apportioned
License Plates assigned to this vehicle.
It is the vehicle Registrant/Operator's responsibility to be compliant with all Federal and Ohio laws, regulations, rules, standards, and orders, that are applicable
while operating this vehicle in to, and throughout, the State of Ohio, as well as any other Foreign Jurisdiction laws, or rules that may apply to the operation of
this Commercial Motor Vehicle while traveling through their jurisdiction. Specifically, Federal Motor Carrier Safety Regulations (49 CFR 350-399); Federal
Hazardous Materials Regulations (49 CFR 107, 171-177); regulations of the Public Utilities Commission of Ohio (PUCO) (Ohio Administrative Code 4901:2); Fuel
Tax requirements of the International Fuel Tax Agreement (IFTA) administered by the Ohio Department of Taxation (R.C. 5728); Special Hauling Permits for
Oversize/Overweight Vehicles and Loads (R.C. 5577) administered by the Ohio Department of Transportation; all State and local traffic laws (R.C. 4511); and
Financial Responsibility laws (R.C. 4509).
BMV 0025 7/19 [760-1066]
Contact the Ohio Bureau of Motor Vehicle's IRP Processing Center at (614) 777-8400, or (800) IRP-0007, for information.
Any alteration or erasures voids this Apportioned Registration Cab Card, and is a misdemeanor of the fourth degree (R.C. 4549.08).
05/27/2021
Arbor Insurance Group Inc.3435 Winchester RdSuite 305Allentown PA 18104
Elizabeth A Meckel, CISR(610) 437-3340 (610) 770-9318
Critical Supply Solutions Inc1300 S Biscayne Point Rd
Miami Beach FL 33141
AIG National Union Fire Ins Co 19445Travelers Property Casualty Company of America 25674
2021 Standard
A GL4673889 06/01/2021 06/01/2022
1,000,000500,00025,0001,000,0002,000,0002,000,000
Employee Benefits 1,000,000
A CA3326219 06/01/2021 06/01/2022
2,000,000
Garage Keepers 500,000
A WC013588192 06/01/2021 06/01/20221,000,0001,000,0001,000,000
BMotor Truck Cargo Legal Liability
QT6603R05506A 06/01/2021 06/01/2022Per Conveyance $250,000Deductible $ 1,000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:
PRODUCER
(A/C, No, Ext):PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBRWVD
ADDLINSD
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.
$
$
$
$PROPERTY DAMAGEBODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLYNON-OWNED
SCHEDULEDOWNEDANY AUTO
AUTOMOBILE LIABILITY
Y / NWORKERS COMPENSATIONAND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?(Mandatory in NH)
DESCRIPTION OF OPERATIONS belowIf yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
EROTH-
STATUTEPER
LIMITS(MM/DD/YYYY)POLICY EXP
(MM/DD/YYYY)POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTRINSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCEDAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYPRO-JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIREDAUTOS ONLY
OH
X
19445 AIG National Union Fire Ins Co
CA3326219 6/1/2021 6/1/2022
ALL OWNED LEASED & HIRED VEHICLES
Arbor Insurance Group Inc.3435 Winchester Rd Suite 305Allentown PA 18104 (610)437-3340
Critical Supply Solutions Inc1300 S Biscayne Point Rd
Miami Beach FL 33141
http://www.arborig.comWeb Address:
INSURANCE IDENTIFICATION CARD
ACORD 50 (2007/02) © ACORD CORPORATION 1983-2007. Allrightsreserved.
(STATE)
COMMERCIAL PERSONALCOMPANY NUMBER COMPANY
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER
AGENCY/COMPANY ISSUING CARD
INSURED
SEE IMPORTANT NOTICE ON REVERSE SIDE
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company assoon as possible. Obtain the following information:
1. Name and address of each driver, passenger and witness.
2. Name of Insurance Company and policy number for eachvehicle involved.
INS050 (200702)
2/28/2021 IMG_8013.jpg
https://drive.google.com/drive/folders/1okigDL7GqVDQEeY5GlyiZTT2D479480f 1/1
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).
ELD MALFUNCTION REPORTING REQUIREMENTS& RECORD KEEPING PROCEDURES
ROADSIDE INSPECTION MODE INTERFACE
Drivers in the event of an ELD Malfunction, are required to:
Carriers in the event of an ELD Malfunction, are required to:
1. Provide written notice to the carrier within 24 hours.
2. Have available accurate electronic or paper logs for the current 24-hour period and the previous 7 days.
3. Continue forward with manually prepared RODS for no more than 8 days.
1. Repair or replace the malfunctioning ELD within 8 days of discovering the condition.
2. Require the driver to maintain paper RODS until the ELD is back in service.
VERSION 06.20
Transfer logs
View next / previous day’s logs
DOT Instruction Sheet (Cont’d)
View required information about driver, vehicle, and carrier
View duty status changes for the day
View required engine data