Issued to
___________________________________________ of _________________________________________________
Dated at ________________________________ this _______ day of _____________________________________, 20_________
Amending Policy No _____________________________ Effective Date ________________________________________________
Name of Insurance Company __________________________________________________________________________________
Countersigned by ______________________________________________________
Authorized Company Representative
The policy to which this endorsement is attached provides primary or excess insurance, as indicated by “[X]," for the limits shown:
[ ] This insurance is primary and
the company shall not be liable for amounts in excess of
$_____________ for each accident.
[ ] This insurance is excess and the company shall not be liable for amounts in excess of $_________ for each accident in excess of the underlying
l
imit of $ __________for each accident.
Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of said
policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA, to verify that the
policy is in force as of a particular date. The telephone number to call is: ________________________.
Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty–five (35) days notice in writing to the other party
(said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is
subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice to
commence from the date the notice is received by the FMCSA at its office in Washington, D.C.).
DEFINITIONS AS USED IN THIS ENDORSEMENT
Accident includes continuous or repeated exposure to conditions
which results in bodily injury, property damage, or environmental
damage which the insured neither expected nor intended.
Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or
semitrailer propelled or drawn by mechanical power and used on a
highway for transporting property, or any combination thereof.
Bodily Injury means injury to the body, sickness, or disease to any
person, including death resulting from any of these.
Property Damage means damage to or loss of use of tangible property.
Environmental Restoration means restitution for the loss, damage, or destruction
of natural resources arising out of the accidental discharge, dispersal, release or
escape into or upon the land, atmosphere, watercourse, or body of water, of any
commodity transported by a motor carrier. This shall include the cost of removal and
the cost of necessary measures taken to minimize or mitigate damage to human
health, the natural environment, fish, shellfish, and wildlife.
Public Liability means liability for bodily injury, property damage, and
environmental restoration.
.
The insurance policy to which this endorsement is attached provides
automobile liability insurance and is amended to assure compliance by the
insured, within the limits stated herein, as a motor carrier of property, with
Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and
regulations of the Federal Motor Carrier Safety Administration (FMCSA).
In consideration of the premium stated in the policy to which this
endorsement is attached, the insurer (the company) agrees to pay, within
the limits of liability described herein, any final judgment recovered against
the insured for public liability resulting from negligence in the operation,
maintenance or use of motor vehicles subject to the financial responsibility
requirements of Sections 29 and 30 of the Motor Carrier Act of 1980
regardless of whether or not each motor vehicle is specifically described in
the policy and whether or not such negligence occurs on any route or in
any territory authorized to be served by the insured or elsewhere. Such
insurance as is afforded, for public liability, does not apply to injury to or
death of the insured's employees while engaged in the course of their
employment, or property transported by the insured, designated as cargo.
It is understood and agreed that no condition, provision, stipulation, or
limitation contained in the policy, this endorsement, or any other
endorsement thereon, or violation thereof, shall relieve the company from liability
or from the payment of any final judgment, within the limits of liability herein
described, irrespective of the financial condition, insolvency or bankruptcy of the
insured. However, all terms, conditions, and limitations in the policy to which the
endorsement is attached shall remain in full force and effect as binding between
the insured and the company. The insured agrees to reimburse the company for
any payment made by the company on account of any accident, claim, or suit
involving a breach of the terms of the policy, and for any payment that the
company would not have been obligated to make under the provisions of the
policy except for the agreement contained in this endorsement.
It is further understood and agreed that, upon failure of the company to pay any
final judgment recovered again the insured as provided herein, the judgment
creditor may maintain an action in any court of competent jurisdiction against the
company to compel such payment.
The limits of the company's liability for the amounts prescribed in this
endorsement apply separately to each accident and any payment under the
policy because of any one accident shall not operate to reduce the liability of the
company for the payment of final judgments resulting from any other accident.
OMB NO: 2126-0008
Expiration Date:03/31/2013
Public Burden Statement
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. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information is estimated to be approximately 2 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 Officer, Federal Motor Carrier Safety Administration, MC-RRA,
Washington, D.C. 20590.
ENDORSEMENT FOR MOTOR CARRIER POLICIES OF INSURANCE FOR
PUBLIC LIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR
CARRIER ACT OF 1980
U.S. Department of Transportation
Federal Motor Carrier
Safety Administration
THE SCHEDULE OF LIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE. The limits shown in the schedule are for information purposes only.
Form MCS-90 (page 1 of 2)
