panther ii transportation, inc
TRANSCRIPT
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
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
Truck Swaps
Owner Swaps
Phone Number Changes
Driver Information Changes
Truck Terminations
Driver Terminations
Fleet Maintenance
Annual DOT Inspections
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]