FORM BMC-84 Revised 05/20/2013 OMB No.: 2126-0017 Expiration: 01/31/2014
FORM BMC-84 Page 1 of 2
United States Department of Transportation
Federal Motor Carrier Safety Administration
A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current
valid OMB Control Number. e OMB Control Number for this information collection is 2126-0017. Public reporting for this collection of information
is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and
reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Ocer, Federal
Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590.
KNOW ALL MEN BY THESE PRESENTS, that we,
as PRINCIPAL (hereinafter called Principal), and
under the laws of the State of
This bond is eective the
Principal as stated herein and shall continue in force until terminated as hereinafter provided. The Principal or the Surety may at any time
cancel this bond by written notice to the Federal Motor Carrier Safety Administration at its oce in Washington, DC, such cancellation to
become eective thirty (30) days after actual receipt of said notice by the FMCSA on the prescribed Form BMC-36, Notice of Cancellation
Motor Carrier and Broker Surety Bond. The Surety shall not be liable hereunder for the payment of any damages herein before described
which arise as the result of any contracts, agreements, undertakings, or arrangements made by the Principal for the supplying of
transportation after the termination of this bond as herein provided, but such termination shall not aect the liability of the Surety
hereunder for the payment of any such damages arising as the result of contracts, agreements, or arrangements made by the Principal
for the supplying of transportation prior to the date such termination becomes eective.
The receipt of this ling by the FMCSA certies that a Broker Surety Bond has been issued by the company identied above, and that
such company is qualied to make this ling under Section 387.315 of Title 49 of the Code of Federal Regulations.
Falsication of this document can result in criminal penalties prescribed under 18 U.S.C. 1001.
America in the sum of $75,000 for a broker or freight forwarder, for which payment, well and truly to be made, we bind ourselves and our
heirs, executors, administrators, successors, and assigns, jointly and severally, rmly by these presents.
WHEREAS, the Principal is or intends to become a Broker or Freight Forwarder pursuant to the provisions of Title 49 U.S.C. 13904, and
the rules and regulations of the Federal Motor Carrier Safety Administration relating to insurance or other security for the protection
of motor carriers and shippers, and has elected to le with the Federal Motor Carrier Safety Administration such a bond as will ensure
nancial responsibility and the supplying of transportation subject to the ICC Termination Act of 1995 in accordance with contracts,
agreements, or arrangements therefore, and
WHEREAS, this bond is written to assure compliance by the Principal as either a licensed Broker or a licensed Freight Forwarder
of Transportation by motor vehicle with 49 U.S.C. 13906(b), and the rules and regulations of the Federal Motor Carrier Safety
Administration, relating to insurance or other security for the protection of motor carriers and shippers, and shall inure to the benet of
any and all motor carriers or shippers to whom the Principal may be legally liable for any of the damages herein described.
NOW, THEREFORE, the condition of this obligation is such that if the Principal shall pay or cause to be paid to motor carriers or shippers
by motor vehicle any sum or sums for which the Principal may be held legally liable by reason of the Principal’s failure faithfully to
perform, fulll, and carry out all contracts, agreements, and arrangements made by the Principal while this bond is in eect for the
supplying of transportation subject to the ICC Termination Act of 1995 under license issued to the Principal by the Federal Motor Carrier
Safety Administration, then this obligation shall be void, otherwise to remain in full force and eect.
The liability of the Surety shall not be discharged by any payment or succession of payments hereunder, unless and until such payment
or payments shall amount in the aggregate to the penalty of the bond, but in no event shall the Surety’s obligation hereunder exceed
the amount of said penalty. The Surety agrees to furnish written notice to the Federal Motor Carrier Safety Administration forthwith of all
suits led, judgements rendered, and payments made by said Surety under this bond.
(hereinafter called Surety), are held and rmly bound unto the United States of
a corporation, or a Risk Retention Group established under the Liability Risk Retention Act of 1986, Pub. L. 99-563, created and existing
of
,
,
,
Broker’s or Freight Forwarder’s Surety Bond under 49 U.S.C. 13906
FORM BMC-84
Filer FMCSA Account Number:
(Name of Broker or Freight Forwarder)
(Name of Surety)
(Street) (City) (State)
(State)
(Zip)
day of 12:01 a.m., standard time at the address of the , ,
19115 68TH AVE S STE H111
Great American Insurance Company
ARCTIC FREIGHT LOGISTICS LLC
