forms catalog

Minnesota Trucking Association2277 Highway 36 West #302Roseville, MN 55113

To order:Phone: (651) 646-7351Fax: (651) [email protected]. mntruck.org

Compliance Products CatalogSave 10 to 25 percent off retail prices on most items!

Receive special pricing by ordering through MTA!

2 0 1 1 - 2 0 1 2 e d i t i o n

See new items on

pages 3, 4, 6, & 9!

Quantity discounts on more items!

2 www.mntruck.orgCall us at (651) 646-7351

TABLE OF CONTENTSLog Books ......................................................................................................... Page 3Driver’s Daily Log BooksDriver’s Daily Log Combined Two-in-One bookHours-of-Service & Driver Logs Workbook

Good Stuff Water Bottle ................................................................................... Page 4

Maintenance & Inspection ............................................................................... Page 5Minnesota Annual Vehicle Inspection ReportRecord of Federal Annual Inspection ReportAnnual Vehicle Inspection Report 3-plySimplified Driver’s Vehicle Inspection ReportDetailed Driver’s Daily Inspection ReportBus Driver’s Vehicle Inspection ReportEquipment File

The Bookshelf ................................................................................................... Page 8Federal Motor Carrier’s Safety Regulations PocketbookFederal Motor Carrier’s Safety Regulations – Management EditionEmergency Response Guidebook, Pocket sizeHazardous Materials Compliance PocketbookCSA Handbook: A complete guide for CMV driversCargo Securement Handbook for DriversCode of Federal Regulations: Title 49 CFR Parts 100-185

Medical Examination ........................................................................................ Page 10Medical Examination Report for Commercial Driver Fitness DeterminationMedical Examination Certificate (card)

Driver Qualification .......................................................................................... Page 11 Driver Qualification FileConfidential All-In-One Driver FileDriver Investigation History File Application for Employment Safety Performance History Records Request Driver Statement of On-Duty HoursCertification of Violations/Annual Review of Driving RecordRecord of Road TestCertification of Road Test Wallet CardsDriver Qualification & Identification Certificate

Other .................................................................................................................. Page 13Accident Reporting Kit

Order JJ Keller Items Through the MTA ......................................................... Page 14

Order Form ....................................................................................................... Page 15

3Minnesota Trucking AssociationCompliance Products Catalog

Item Number

Retail Price

Non-Member Price

Member Price

C0520 $2.98 $2.75 $2.25

Item Number

Retail Price

Non-Member Price

Member Price

C0530 $5.23 $4.75 $3.95

Driver’s Daily Log BooksEasy-to-use log books with daily log on the front and detailed driver’s vehicle inspection report on the back. The driver’s daily log book helps satisfy the duty status requirements on 49 CFR Section 395.8. This log book includes record of duty status regulations on the inside back cover to simplify log completion. A monthly summary sheet and 7- and 8-day recap helps drivers quickly determine their hours available. Size: 8” X 5 1/2”, 2-ply carbon, 31 sheets.

Driver’s Daily Log Combined Two-In-One Book Two-In-One Log Books save time by helping you satisfy 49 CFR Sections 395.8, 396.11, and 396.13. Driver’s Daily Log and Driver’s Vehicle Inspection report on same page, perforated so inspection report can be detached. Log completion instructions on back cover reduce the chances of recordkeeping errors that could lead to costly fines.

Monthly summary sheet on front cover. 8-1/2” x 11”, 2-ply, carbon, 31 sheets.

LOG BOOKS

Item Number

Retail Price

Non-Member Price

Member Price

C0525 $3.34 $2.95 $2.55

Driver’s Daily Log Books with no DVIRSame as above but 2-ply, carbonless and no DVIR.

Item Number

Retail Price

Non-Member Price

Member Price

C0540 $11.49 $10.25 $9.25

LOG BOOKSHours-of-Service & Driver Logs WorkbookYes, the Hours of Service rules may be changing, but the final rule won’t be published until October 2011 (at the earliest) and there could be a significantly-delayed mandatory compliance date. In the meantime, your drivers can get the hands-on logging practice they need to comply with FMCSA’s current rules governing hours-of-service for commercial truck drivers.

Used for self-learning, as a one-on-one training tool, or in the classroom, this workbook is packed with logbook exercises (calculating sleeper berth use, the 11-hour driving limit, 14 consecutive hours-on duty rule, 60/70 driving limits, and the 34-hour restart provision) that can get your drivers up to speed quickly. This handy workbook also includes plain-English explanations of the regs and log page samples that you can use to illustrate specific situations and problems. Spiral-bound, 8-1/2” x 10-13/16”, 182 pages.

You can’t find these anywhere else! “Good Stuff Trucks Bring It™” stainless steel water bottles, available only through the MTA.

• The perfect safe-driving reward for your drivers • A nice perk for employees or customers • A great way to spread the image of Trucking as essential

These striking bottles are BPA-free and keep your beverage fresh and good-tasting. Silver, 7-1/2” high, 17 ounces.

Each bottle is just $10.75.

Item Number: C0001Contact Lori at 651-646-7351 or [email protected] to order.

Exclusive MTA “Good Stuff” Water Bottles Now Available!

www.mntruck.orgCall us at (651) 646-7351


Item Number

Non-Member Price

Member Price

AVI $11.50 $9.50

PERIODIC VEHICLE INSPECTION REPORT

1. Date MM/DD/YYYY 2.Insp.Location(Address) 3. Time(AM / PM ) 4. DECAL# 5.Veh Make 6.Mod.Yr 7.Unit#

8.Odometer Reading (C or H) 9. VIN# 10.Lic# 11.State

12.Owner Name 13.Owner Str. Address 14. City, State, ZIP

15.Carrier Name 16.Carrier Str. Address 17.City, State, ZIP

18.Owner USDOT# 19. Carrier USDOT# 20.Inspector Name 21.Inspector #

PASS FAIL N/A PASS FAIL N/A

1. BRAKE SYSTEM c. Brake lamps a. Service Brakes d. Turn Signals 1.) Adjustment e. Marker/ID/Clearance Lamps 2.) Pads f. Conspicuity Tape/Reflectors b. Parking Brake System 6. LOAD SECUREMENT c. Brake Drum or Rotors 7. STEERING MECHANISM d. Brake Hose a. Steering Wheel Free Play(Lash) e. Brake Tubing b. Steering Column f. Low Pressure/Vacuum and/or Low Air Warning Device

c. Front Axle Beam & All Components Other Than Steering

g. Tractor Protection Valve d. Steering Gear Box Column h. Air Compressor e. Pitman Arm i. Electric Brakes f. Power Steering

g. Ball & Socket Joints

h. Tie Rods & Drag Link

j. Hydraulic Brakes (including Power assist over Hydraulic & Engine Drive Hydraulic Booster)

i. Nuts

k. Vacuum Systems j. Steering System

l. Brake Away Brakes on Trailer 8. SUSPENSION

2. COUPLING DEVICES a. U-Bolts

a. 5th Wheel & Mounting/King Pin b. Spring Assembly

b. Pintle Hooks & Mounting Ball hitch

c. Torque, Radius, or Tracking Components

c. Drawbar /Towbar Eye 9. FRAME/INCLUDING CROSS FRAMES

d. Drawbar/Towbar Tongue a. Frame Members

e .Safety Devices (chains, cables, hooks)

b. Tire & Wheel Clearance

f. Saddle Mounts c. Adjustable Axle Assemblies(sliding subframes) & Locking Devices

g. Locking Devices 10. TIRES

3. EXHAUST SYSTEM 11. WHEELS & RIMS

4. FUEL SYSTEM a. Lock or Slide Ring

a. Visible Leak b. Wheels & Rims

b. Fuel Cap c. Fasteners (lugs)

c. Securement of Tank d. Welds

5. LIGHTING DEVICES 12. WINDSHIELDS/Glazing

a. Headlamps 13. WIPERS/WASHER & DEFROSTERS

b. Tail Lamps

14. REAR VISION MIRRORS 17. REAR END PROTECTION

15. HORN 18. HOOD, FRONT BUMPER, BODY PARTS

16. FIRE EXTINGUISHER & TRIANGLES 19. WHEEL FLAPS

THIS VEHICLE IS IN COMPLIANCE WITH 49 CFR 396.17 APPENDIX G

I hereby certify that the above information is true and accurate.

Inspector Signature ____________________________________

This is the only vehicle inspection form approved by the Minnesota State Patrol. (2008-9)

MAINTENANCE & INSPECTIONANNUAL VEHICLE INSPECTION REPORTS

Minnesota Annual Vehicle Inspection ReportDesigned and approved by the Minnesota State Patrol, this pad contains 50 duplicate carbonless inspection forms. Includes a note page and decal record.

The MTA offers Minnesota Annual Vehicle Inspection Certification and Re-certification classes. See our Web site, www.mntruck.org and click on “Event Registration” for additional details and dates, or call (651) 646-7351.

Record Of Federal Annual Inspection ReportThese 2-ply, carbonless forms help you meet applicable DOT requirements. They are in continuous format, 8-1/2”x11” detached. The form can be ordered without decals, or with a black, fade-resistant decal for trucks, tractors, trailers, and dollies. The forms and decals are consecutively numbered. Decals and clear decal overlays are also available separately.

C1685 – Annual Inspection Report, no Attached DecalC1686 – Annual Inspection Report with Attached DecalsC1687 – Individual Federal Annual Inspection Decals C1689 – Individual Federal Annual Inspection Decal Overlays

Certification $180Re-certification $90

Item Number

Retail Price

Non-Member Price

MemberPrice

C1685 $0.66 $0.59 $0.49C1686 $0.84 $0.75 $0.63C1687 $0.37 $0.35 $0.33C1689 $0.14 $0.12 $0.10


Something you want that you don’t see? Call us at (651) 646-7351

Simplified Driver’s Vehicle Inspection Report Simplified version of the inspection report with 15 inspection areas. Helps drivers comply with 49 CFR Sections 396.11 and 396.13. Book of 31 lists 15 inspection areas and has space to record any defects.

C1760 – Duplicate, carbonless C1770 – Triplicate, w/carbon interleaf

Federal Annual Vehicle Inspection Report – 3-plyThese 3-ply, carbonless forms help you meet DOT’s annual vehicle inspection requirements. Durable 100 lb. manila ply helps preserve the report. Snap-out format, 8-½” x 11-¾”.

DAILY VEHICLE INSPECTION REPORTS

Item Number

RetailPrice

Non-Member Price

Member Price

C1690 $0.71 $0.63 $0.58

Detailed Driver’s Daily Inspection Report – Duplicate, carbonlessDetailed DVIRs list specific tractor and trailer parts to help simplify inspection. Drivers simply check off parts that need repair. Includes key regulations printed on inside front cover to remind drivers of DOT-required procedures. Book of 31.

Item Number

Quantity Retail Price

Non-Member Price

MemberPrice

C1760 1-99 $3.26 $2.95 $2.45C1760 100+ $2.88 $2.59 $2.15C1770 1-99 $2.70 $2.45 $2.15C1770 100+ $2.50 $2.25 $2.00

Item Number


Non-Member Price

MemberPrice

C1790 1-99 $3.25 $2.95 $2.45C1790 100+ $2.88 $2.55 $2.15


Item Number

Retail Price

Non-Member Price

Member Price

V0300 $1.33 $1.20 $1.10

Item Number

RetailPrice

Non-Member Price

Member Price

C1740 $3.83 $3.45 $2.85

Detailed Driver’s Vehicle Inspection Report - Triplicate w/Carbon InterleafDetailed DVIRs list specific tractor and trailer parts to help simplify inspections. Drivers simply check off parts that need repair. Easy-to-use forms helps drivers comply with 49 CFR Sections 396.11 and 396.13. Book of 31.

Bus Driver’s Vehicle Inspection ReportDesigned for proper recording of pre-trip and post-trip bus inspec-tions to help meet FMCSR requirements. Carbonless, 5-1/2”x 8-1/8”, book of 31.

ATA VMRS 2000™ Equipment FileKeep a well-organized file on each truck and trailer. With this useful 12”x 9” file folder, you can record a quick profile of the unit’s maintenance history. This form works well for maintenance shops and central fleet maintenance control facilities.

DAILY VEHICLE INSPECTION REPORTS (cont’d)

Item Number


Non-Member Price

MemberPrice

C1780 1-99 $2.70 $2.45 $2.05C1780 100+ $2.62 $2.35 $1.95



Item Number

Retail Price

Non-Member Price

Member Price

C0875 $14.19 $13.50 $12.50

Item Number


Non-Member Price

MemberPrice

C0985 1-24 $3.69 $3.30 $3.10C0985 25-49 $3.39 $3.15 $2.95C0985 50-99 $3.29 $3.05 $2.85C0985 100+ $3.19 $2.90 $2.70

Federal Motor Carrier Safety Regulations PocketbookUpdated monthly for the most current information and specially designed for fast reference, this convenient, affordable fleet safety resource contains word-for-word reprints of DOT’s FMCSRs. The pocketbook offers critical regulatory information on alcohol and drug testing, CDL standards, financial responsibil-ity for carriers, safe operation, driver qualification, hours of service, hazardous materials, vehicle inspection/repair/maintenance, and more. Measures 4”x 6”, perfect bound, 736 pages.

Federal Motor Carrier Safety Regulations Management EditionSpecially designed for fast reference, this convenient, affordable fleet safety resource contains word-for-word reprints of DOT’s FMCSRs, with interpreta-tions printed immediately following many of the regulations. It also includes vi-tal medical regulatory criteria, and regulatory histories, making it an excellent reference for management. Measures 8-1/2”x11”, perfect bound. 608 pages.

Emergency Response Guidebook, pocket size (good through 2012)This guidebook helps you satisfy 49 CFR 172.602 - DOT’s requirement that hazardous materials shipments be accompanied by emergency response information. Numerically indexed and color-coded, the ERG helps emergency responders find vital information fast. It’s also a great tool to aid in emergency preparedness, planning, and training. Soft bound, 376 pages.

THE BOOKSHELF

Item Number


Non-Member Price

MemberPrice

C0870 1-24 $3.89 $3.60 $3.05C0870 25-49 $3.69 $3.45 $2.95C0870 50-99 $3.29 $3.05 $2.65C0870 100+ $2.89 $2.70 $2.35


Item Number


Non-Member Price

MemberPrice

C0995 1-24 $4.59 $4.20 $3.45C0995 25-49 $4.39 $3.95 $3.25C0995 50-99 $4.29 $3.85 $3.20C0995 100+ $3.99 $3.65 $3.00

Hazardous Materials Compliance PocketbookThis easy-to-read pocketbook gives your drivers fast access to the current regulatory information they need to check placards, labels, markings and shipping papers for compliance with hazardous materials regulations. That’s critical, because informed drivers can reduce the chances of accidents, hazardous materials incidents, and costly DOT fines for non-compliance. Softbound, 592 pages.

Cargo Securement Handbook for DriversThis handy little book combines cargo securement regulations – plus practical, hands-on guidance and illustrated best practices – into one convenient source. It helps drivers determine the best cargo securement methods for the type of cargo they’re transporting, based on government regulations and provides need-to-know guidelines on proper use of blocks, ropes, chains, bars and more for flatbeds, dry vans, reefers and other types of trailers. Includes a tiedown quick reference, FAQs and much more. Spiral-bound, 192 pages.

Item Number


Non-Member Price

MemberPrice

C0880 1-9 $7.59 $7.20 $6.45C0880 10-24 $7.19 $6.80 $6.10C0880 25-49 $6.59 $6.25 $5.60C0880 50+ $6.29 $5.95 $5.35

THE BOOKSHELF

CSA Handbook: A Complete Guide for CMV DriversThis compact, spiral-bound, 227-page handbook covers all information CMV interstate truck and bus drivers need to operate successfully under CSA. A great tool for training and reference, and is the ideal in-cab reference for helping drivers improve their compliance scores.

Item Number


Non-Member Price

MemberPrice

C1200 1-9 $7.59 $7.20 $6.85C1200 10-24 $7.19 $6.85 $6.50C1200 25-49 $6.59 $6.25 $5.95C1200 50-99 $6.29 $5.95 $5.65C1200 100+ $5.59 $5.30 $5.05



Item Number


Non-Member Price

MemberPrice

C0750 1-9 $1.41 $1.30 $0.70C0750 10-49 $1.31 $1.20 $0.65C0750 50-99 $0.74 $0.65 $0.40C0750 100+ $0.67 $0.59 $0.35

Item Number


Non-Member Price

MemberPrice

C0755 1-9 $6.18 $4.00 $2.00C0755 10-49 $4.38 $3.70 $1.90C0755 50-99 $2.47 $2.10 $1.10C0755 100+ $2.18 $1.85 $0.95

Item Number


Non-Member Price

MemberPrice

C0730 1-9 $4.77 $3.10 $1.60C0730 10-49 $3.07 $2.90 $1.50C0730 50-99 $1.73 $1.60 $1.35C0730 100+ $1.51 $1.45 $0.80

Medical Examination Report for Commercial Driver Fitness DeterminationThese forms will help you comply with 49 CFR §391.43. The report is eight pages and contains applicable regulations, instructions to the medical examiner, and the form itself.

Medical Examination Certificate (Card) for Commercial Driver Fitness DeterminationPhysical examination forms to help you comply with 49 CFR §391.43. Two-ply, self-laminating.

SET - Medical Examination Report and Certificate (Card)

MEDICAL EXAMINATION

Item Number

Retail Price

Non-Member Price

Member Price

C0501 $37.99 $34.25 $30.00

Code of Federal Regulations: Title 49 CFR Parts 100-185 If you want the latest reprint of DOT’s Regulations for Hazardous Materials & Oil Transportation, the Code of Federal Regulations is the most affordable solution. This convenient resource contains the regs under 49 CFR Parts 100.185, printed word for word. 8”x9”, 1,254 pages.

THE BOOKSHELF (cont’d)


Confidential All-In-One Driver FileThis convenient and comprehensive packet allows you to keep Alcohol & Drug Forms, Safety Performance History Forms and Driver Qualification Forms secure and in one convenient location. Each confidential file folder includes the following two-copy forms:

Driver Qualification Forms • Additional Employment History Information • Application For Employment • Driver Qualification And Identification Certificate

Pocket Card • Certificate Of Road Test Pocket Card• Certificate of Compliance • Checklist for Qualification of New Drivers • Driver’s Statement of On-Duty Hours-New Hire • Employee Record Card • Driver Qualification File Contents Sheet • Employment Eligibility Verification I-9 • Fair Credit Reporting Act Disclosure Statement • Medical Examiner’s Certificate • Medical Examination Report • Notice To Drivers And Certification Of Compliance • Record And Certificate of Road Test • Request For Check Of Driving Record • Record Of Violations/Annual Review

Alcohol & Drug Forms • Alcohol & Drug Employee’s Certified Receipt • Alcohol & Drug Records Request • Alcohol And/Or Controlled Substance Test Notifica-

tion • Drug Test Results • Federal Drug Testing Custody And Control Form • Observed Reasonable Suspicion Record • Previous Pre-employment Alcohol & Drug Test

Statement • U.S. Department Of Transportation Alcohol Testing

Form

Safety Performance History Forms • Previous Employee Safety Performance History• Safety Performance History Records Request (3)

Item Number

RetailPrice

Non-Member Price

Member Price

C0601 $7.15 $6.50 $5.35

Item Number

Retail Price

Non-Member Price

Member Price

C0602 $4.27 $3.85 $3.20Item Number

RetailPrice

Non-Member Price

Member Price

C0603 $17.31 $15.50 $12.95

Driver Qualification File This conveniently organized file provides the forms you need to meet driver qualifica-tion requirements for one driv-er. Folder is pre-printed with file contents and instructions for each form and includes:

• Additional Employment History Information

• Application For Employment • Driver Qualification And Identification Certificate

Pocket Card • Certificate Of Road Test Pocket Card• Certificate of Compliance • Checklist for Qualification of New Drivers • Driver’s Statement of On-Duty Hours-New Hire • Employee Record Card • Driver Qualification File Contents Sheet • Employment Eligibility Verification I-9 • Fair Credit Reporting Act Disclosure Statement • Medical Examiner’s Certificate • Medical Examination Report • Notice To Drivers And Certification Of Compliance • Record And Certificate of Road Test • Request For Check Of Driving Record • Record Of Violations/Annual Review

Driver Investigation History FileThis file helps you comply with the Safety Perfor-mance History record keeping requirement. Each file folder includes:• Previous Employee Safety Performance History• Safety Performance History Records Request (3)

DRIVER QUALIFICATION



Item Number

Retail Price

Non-Member Price

Member Price

C0720 $0.73 $0.65 $0.60

Application for Employment – Paper 4-page employment application helps you comply with 49 CFR Section 391.21 and ADA regulations.

History Records Request Form Use this combination form to help satisfy 49 CFR §391.23(a)(2), (d), and (e), which require the prospective employer to obtain driver identification, employment and accident history, and alcohol & drug testing information from a driver/applicant’s previous employers. This form covers: • Driver/applicant’s authorization to release information • Employment verification and accident information (including • date, location, injuries, fatalities, and hazardous material spill • details) • Alcohol and drug test information (including previous tests, refusals, and

rehabilitation)

Driver Statement of On-Duty Hours When using a driver for the first time or intermittently, motor carriers must obtain a signed statement from the driver giving the driver’s total time on-duty during the immediately preceding seven days. Use this driver’s data sheet to stay in compliance with FMSCR Section 395.8(j)(2). Pad of 50.

Item Number

RetailPrice

Non-Member Price

Member Price

C0860 $8.95 $8.05 $6.70


Item Number


Non-Member Price

MemberPrice

C0770 Pad of 50 $8.51 $7.65 $6.35



Item Number

RetailPrice

Non-Member Price

Member Price

C0680 $8.95 $8.05 $6.70

Certification of Violations/Annual Review of Driving Record This form helps employers stay in compliance with the requirement to check drivers’ records every 12 months. Pad of 50.

Item Number

Retail Price

Non-Member Price

Member Price

C0790 $8.95 $7.65 $6.70

Record of Road Test Meets requirements for Section 391.35 of the Federal Motor Carrier Safety Regulations. Pad of 50.

Certification of Road Test Wallet Cards Meets requirements for Section 391.35 of the Federal Motor Carrier Safety Regulations. Pad of 50.

Driver Qualification & Identification Certificate Annual review of driving record certification card meets requirements for Section 391.35 of the Federal Motor Carrier Safety Regulations.

Item Number

RetailPricing

Non-Member Price

Member Price

C0810 $4.19 $3.75 $3.35

OTHER

Accident Reporting Kit These concise, thorough, and easy-to-use kits pro-vide a quick and efficient way for drivers to collect and report necessary accident information. Package includes: • Memo Accident Report to record info required

for state and insurance reports and the accident register

• Witness Cards (4) • Exoneration card • Pen • 6” x 9” Envelope to keep the forms together

Camera is extra. Cost breaks are available on quantities above 25. Please call for pricing.

Item Number

RetailPrice

Non-Member Price

Member Price

C0701 $0.37 $0.33 $0.28Item Number

RetailPrice

Non-Member Price

Member Price

C1600 $0.37 $0.33 $0.27

Check your JJ Keller catalog or go to www.jjkeller.com to look for the items you need.Call the MTA at (651) 646-7351 to get your reduced price!

Did you know you can get 5 to 10 percent offJJ Keller items when you order through the MTA?

• Cargo Securement

• CSA 2011 Information

• Driver, Vehicle and Dock supplies

• Fleet operations

• Hazmat

• Human Resources

• Safety and Security

• Training books and DVDs

• Vehicle Inspection & Maintenance

COMPLIANCE PRODUCTS ORDER FORM

How to order:Call in your order at (651) 646-7351Fax this order form to (651) 641-8995E-mail your order to [email protected] this form to: Minnesota Trucking Association 2277 Highway 36 West #302 Roseville, MN 55113

C0001 Good Stuff Trucks Bring It™ Aluminum Water Bottle w/ Caribiner $10.75 $10.75AVI Minnesota Annual Vehicle Inspection Report $11.50 $9.50C0501 Code of Federal Regulations: Title 49 CFR Parts 100-185 $34.25 $30.00C0520 Driver’s Daily Log Book $2.75 $2.25C0525 Driver’s Daily Log Book w/ no DVIR $2.95 $2.55C0530 Driver’s Daily Log Combined Two-in-One Book $4.75 $3.95C0540 Hours of Service & Driver Logs Workbook $10.25 $9.25C0601 Driver Qualification File $6.50 $5.35C0602 Driver Investigation History File $3.85 $3.20C0603 Confidential All-In-One Driver File $15.50 $12.95C0680 Certification of Violations/Annual Review of Driving Record $8.05 $6.70C0701 Certification of Road Test Wallet Cards $0.33 $0.28C0720 Application for Employment - Paper $0.65 $0.60C0730 Medical Examination Report (Qty: 1-9) $3.10 $1.60C0730 Medical Examination Report (Qty: 10-49) $2.90 $1.50C0730 Medical Examination Report (Qty: 50-99) $1.60 $1.35C0730 Medical Examination Report (Qty: 100+) $1.45 $0.80C0750 Medical Examination Certificate - Card (Qty: 1-9) $1.30 $0.70C0750 Medical Examination Certificate - Card (Qty: 10-49) $1.20 $0.65C0750 Medical Examination Certificate - Card (Qty: 50-99) $0.65 $0.40C0750 Medical Examination Certificate - Card (Qty: 100+) $0.59 $0.35C0755 Medical Examination Certificate - SET (Qty: 1-9) $4.00 $2.00C0755 Medical Examination Certificate - SET (Qty: 10-49) $3.70 $1.90C0755 Medical Examination Certificate - SET (Qty: 50-99) $2.10 $1.10C0755 Medical Examination Certificate - SET (Qty: 100+) $1.85 $0.95C0770 Safety Performance History Records Request Form– pad of 50 $7.65 $6.35C0790 Record of Road Test $7.65 $6.70C0810 Accident Reporting Kit $3.75 $3.35C0860 Driver Statement of On-Duty Hours $8.05 $6.70C0870 Federal Motor Carrier Safety Regulations Pocketbook (Qty: 1-24) $3.60 $3.05C0870 Federal Motor Carrier Safety Regulations Pocketbook (Qty: 25-49) $3.45 $2.95C0870 Federal Motor Carrier Safety Regulations Pocketbook (Qty: 50-99) $3.05 $2.65C0870 Federal Motor Carrier Safety Regulations Pocketbook (Qty: 100+) $2.70 $2.35C0875 Federal Motor Carrier Safety Regulations Management Edition $13.50 $12.50C0880 Cargo Securement Handbook for Drivers (Qty: 1-9) $7.20 $6.45C0880 Cargo Securement Handbook for Drivers (Qty: 10-24) $6.80 $6.10C0880 Cargo Securement Handbook for Drivers (Qty: 25-49) $6.25 $5.60

Item Number

Product Name Non-member Price

MTA Member Price

Quan-tity

Item Number

Product Name Non-member Price

MTA Member Price

Quantity

C0880 Cargo Securement Handbook for Drivers (Qty: 50+) $5.95 $5.35C0985 Emergency Response Guidebook, pocket size (Qty: 1-24) $3.30 $3.10C0985 Emergency Response Guidebook, pocket size (Qty: 25-49) $3.15 $2.95C0985 Emergency Response Guidebook, pocket size (Qty: 50-99) $3.05 $2.85C0985 Emergency Response Guidebook, pocket size (Qty: 100+) $2.90 $2.70C0995 Hazardous Materials Compliance Pocketbook (Qty: 1-24) $4.20 $3.45C0995 Hazardous Materials Compliance Pocketbook (Qty: 25-49) $3.95 $3.25C0995 Hazardous Materials Compliance Pocketbook (Qty: 50-99) $3.85 $3.20C0995 Hazardous Materials Compliance Pocketbook (Qty: 100+) $3.65 $3.00C1200 CSA Handbook: A Complete Guide for CMV Drivers (Qty: 1-9) $7.20 $6.85C1200 CSA Handbook: A Complete Guide for CMV Drivers (Qty: 10-24) $6.85 $6.50C1200 CSA Handbook: A Complete Guide for CMV Drivers (Qty: 25-49) $6.25 $5.95C1200 CSA Handbook: A Complete Guide for CMV Drivers (Qty: 50-99) $5.95 $5.65C1200 CSA Handbook: A Complete Guide for CMV Drivers (Qty: 100+) $5.30 $5.05C1600 Driver Qualification & Identification Certificate $0.33 $0.27C1685 Federal Annual Inspection Report - no decal $0.59 $0.49C1686 Federal Annual Inspection Report with attached decals $0.75 $0.63C1687 Individual Federal Annual Inspection decals $0.35 $0.33C1689 Individual Federal Annual Inspection decal overlays $0.12 $0.10C1690 Federal Annual Inspection Report, 3-ply $0.63 $0.58C1740 Bus Driver’s Vehicle Inspection Report $3.45 $2.85C1760 Simplified Driver’s Vehicle Inspection Report, duplicate, carbonless (Qty: 1-99) $2.95 $2.45C1760 Simplified Driver’s Vehicle Inspection Report, duplicate, carbonless (Qty: 100+) $2.59 $2.15C1770 Simplified Driver’s Vehicle Inspection Report, triplicate, carbon (Qty: 1-99) $2.45 $2.15C1770 Simplified Driver’s Vehicle Inspection Report, triplicate, carbon (Qty: 100+) $2.25 $2.00C1780 Standard Driver’s Vehicle Inspection Report, triplicate, carbon (Qty: 1-99) $2.45 $2.05C1780 Standard Driver’s Vehicle Inspection Report, triplicate, carbon (Qty: 100+) $2.35 $1.95C1790 Detailed Driver’s Daily Inspection Report, duplicate, carbonless (Qty: 1-99) $2.95 $2.45C1790 Detailed Driver’s Daily Inspection Report, duplicate, carbonless (Qty: 100+) $2.55 $2.15V0300 VMRS 2000™ Equipment File $1.20 $1.10

Payment Options: q Invoice Me q Pay by Credit Card

Credit card: _______________________________________Exp. Date: ________________________

Name on Card: ____________________________________CVO: _____________________________

Company: __________________________________________________________________________

Name: _____________________________________________________________________________

Address: ___________________________________________________________________________

City: ___________________________ State: _____________________ Zip: ____________________

Phone: _________________ Fax: ____________________E-mail: ___________________________

PO # (if required) ___________________________________Date: _____________________________

Note: Minnesota sales tax and shipping/handling will be added to your order.Prices are subject to change

Three or four digit number on back of card.

forms catalog

Documents

drivers daily log bookseasy

maintenance inspection

medical examination

duty status requirements

cfr parts

cfr section

order form

table of contentslog