Orange County NC Website
DocuSign Envelope ID: E53DCC3C-B8E8-410C-BB50-A039C27BD393 <br /> I1= <br /> f � Tradebe Environmental Services, LLC. <br /> 0606E� <br /> 1433 E. 83rd Ave., Ste. 200 <br /> TRADEB E Merrillville, IN 46410 <br /> row mmso tieasedi}1Io5f-'o17 DMI3 No.;212r.4008 Expiration,K:n.2020 <br /> USDOTNaniber: 4415275 DataReceised; <br /> AFEderd AeeeEvmas not cauduct of sponscv.and a pEiA- r sa oDi regmred[a respond io,nmr ahaIla person to subject rD a pemalty:or faihure ro Eomplf <br /> Witt]aca,Teaiacofiaformaizom subiEErto rheregn�To,r�n�,of thePapwwwk REdutti�A€tuEhm dw aoDectiooafinfa m&r LiplM a Emrent <br /> valid OMB ccrrdNumbEr.TheOAMComaolNumtifar this inf(maikmmlle€tkmis'_1'Y-Ma PublicrepMtT9'Dr Ibis 0OAKdaoaCiJ3k0r Cn <br /> ii esonAed[D be approvmatels 2 miunrea pEr rapmo e,int1dieg[he tine fat miEwiug Wsowtb us. Euhericg lhE data ceaded-and€ompbaing aad <br /> raviewingthEccAEainuoCiEd mamnAUiEFpomseatodscolYKtlamofmfmmaciocaremamdurmy.Send€ommentsmgwdicgthtlurErEsti:=eor <br /> ausucl_caspectofthis€ultecleuoOfinf=dor,inckdingnrsuggesdms for re&Lcingthisburden to:h3RQmaticmCol-'BctiamClearance Offixr,Federal <br /> 1dn[or Cotner SidErr Admmmtraaori` C-RRA,%G stdagron-D.C.T45B0. <br /> United States Deps rtmer t cf Transportation <br /> Federal Motor Carrier Safety Administration <br /> Endorsement for Motor Carrier Policies of Insurance for PUNC Liability <br /> under Sections 29 and 30 of the Motor Carrier Act of 1980 <br /> FORMMCS-90 <br /> Issued toTradebe Transportation-LLC of Indiana <br /> NOW l3k,srCrnzlat=rarQveymvirra, <br /> Dated at10:21AM on this2191 day of December 12017 <br /> AmenciingPalicyNumber. BAP 100925a-03 Effective Date: 12131f2017 <br /> Name of Insurance Company 2urieh AmBriean Insurance CorSpaTif <br /> Countersigned by: <br /> fsh uv-_=rampalq rvp�v:un ,a' <br /> The porky to which this endorsement is attached provides primary or excess i nsurance,as indicated for the I im its shaven (UpEck aa'y one): <br /> jKIkiss[mnvwv rpriaaan•fmddharo?VmD hminorbefigblvjtiranwimarerr qfZ ZM,000 1bI4WCAOCCLIfff. <br /> ❑77hfs mrivmwe isrttrar and AV caagpa�e_Jh79 Rar 4!roft'4b7a MMML,fa�of f Aronxh arradrm A—OfAr <br /> [r&*Mg iimlr VL fffamch urcidfm <br /> Whenever required by the Federal Mptar Carrier Wety Administration(FhfGSA),the company agrees to fumish the FLIGA a duplicate cif <br /> said pdicy and all its enco emerimThecorWany also agrees.upon telephone request by en suthoriaed representative of the FMGSA , <br /> to verify that the policy is in fuse as cif aparticular date.The telephone number to call is 8171,M-2150 <br /> Cancellation of this endorsement mayheeffectedbythecompanypftheinsuredbygiving(1)thirty-five(35)daysnoticeinwritngto <br /> the oche r party(sand 35 days notice Lo commence from th a date th e netioe is maned,Proof of mailing shalt be suffideru proof of nodue), <br /> and(2)if the insured is subject tp the FMCSAI,registration requirements under 49 U.S.G-13901,by provid in g thirty(3D)days nonce to <br /> the FW—M(said 30 days notice to commence from the date the notice is received l y the FMC:34 431 its offioe i n Washington,DCy. <br /> Flings must be transmitted anline via the Intemetat htty:ffwww.fmcsa.dot.novrurs_ <br /> oonfrrrued on next pa4e) <br /> FORMM &M Page iof9 <br /> Sustainability at Work 59 <br />