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The DMV 65 MCP form plays a crucial role in ensuring that motor carriers of property maintain the necessary insurance coverage as mandated by California law. This form serves as a Certificate of Insurance, confirming that the motor carrier is protected by a valid insurance policy that meets the requirements outlined in the California Vehicle Code and federal regulations. Key details included in the form encompass the name and address of both the motor carrier and the insurer, as well as the policy number, effective dates, and coverage limits. The insurer must certify that the policy covers all vehicles used in the carrier's operations, regardless of whether those vehicles are explicitly listed in the policy. Furthermore, the form stipulates that any cancellation of the insurance must be communicated to the DMV with at least thirty days' notice. This ensures that there is no lapse in coverage, which could jeopardize the carrier's operations. Additionally, specific provisions apply to charitable risk pools and risk retention groups, highlighting the form's comprehensive nature. By signing the DMV 65 MCP, the insurer affirms the accuracy of the information provided, reinforcing the importance of transparency and compliance in the insurance process for motor carriers.

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DATE RECEIVED BY DMV

CERTIFICATE OF INSURANCE

Motor Carriers of Property

MOTOR CARRIER (CA) #

INSURER (INSURANCE COMPANY) NAME AND ADDRESS

NAIC #

 

Status:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Licensed to write insurance in the State of California

 

 

SURPLUS LINE BROKER #

 

 

(Admitted Insurer)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nonadmitted Insurer subject to Section 1763 of the

 

 

OTHER #

 

 

 

 

California Insurance Code. ______________________

 

 

 

 

 

 

 

 

 

 

Charitable Risk Pool

SURPLUS LINE BROKER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk Retention Group

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURED (MOTOR CARRIER) NAME AND ADDRESS

 

 

 

Filed with the:

California Department of Motor Vehicles

 

 

 

 

 

 

 

 

 

 

 

 

Motor Carrier Services Branch

 

 

 

 

 

 

 

P. O. Box 932370

MS G875

 

 

 

 

 

 

 

Sacramento, CA 94232-3700

 

 

 

 

 

 

 

(916) 657-8153

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF INSURANCE

POLICY NUMBER

 

POLICY EFFECTIVE

 

 

LIMITS

 

DATE (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIMARY LIABILITY

 

 

 

 

 

COMBINED SINGLE LIMIT

 

$

 

 

 

 

 

 

 

 

 

 

Coverage below statutory minimum

 

 

 

 

 

BODILY INJURY OR DEATH

 

$

limits.

 

 

 

 

 

(ONE PERSON)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BODILY INJURY OR DEATH

 

$

Coverage equal to or exceeding

 

 

 

 

 

(MORE THAN ONE PERSON)

 

 

 

 

 

 

 

 

statutory minimum limits.

 

 

 

 

 

PROPERTY DAMAGE

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMBINED SINGLE

 

 

 

EXCESS LIABILITY

 

 

 

 

 

LIMIT

 

$ _______ in excess of $ _____________

 

 

 

 

 

 

 

 

 

 

Coverage between primary cover-

 

 

 

 

 

BODILY INJURY

 

 

 

 

 

 

 

 

(ONE PERSON)

$ _______ in excess of $ _____________

age and statutory minimum limits.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BODILY INJURY OR

 

 

 

Coverage provided at or above

 

 

 

 

 

DEATH (MORE THAN

$ _______ in excess of $ _____________

statutory minimum limits.

 

 

 

 

 

ONE PERSON)

 

 

 

 

 

 

 

 

 

PROPERTY DAMAGE

$ _______ in excess of $ _____________

 

 

 

 

 

 

 

 

 

 

WORKERS’ COMPENSATION

 

 

 

 

 

WC Statutory Limits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurer certifies to each of the following:

that the motor carrier of property (Insured) identified herein is covered by an insurance policy providing bodily injury or death liability, property damage liability insurance, or workers’ compensation insurance within the coverage limits identified above as required by California Vehicle Code (CVC) Section 34630, 34631.5, and 34640, and by Part 387 of Title 49 of the Code of Federal Regulations.

that this insurance policy covers all vehicles used in conducting the service performed by the Insured for which a motor carrier permit is required whether or not said vehicle is listed in the insurance policy.

that a fully executed Endorsement, on a form authorized by the Department of Motor Vehicles (DMV), is attached to the referenced policy to conform to the requirements of the Motor Carriers of Property Permit Act, CVC Section 34600 and following, and the rules and regulations of the DMV. (This provision does not apply to Workers’ Compensation Insurance.)

that for the purposes of Charitable Risk Pool coverage, this policy meets the requirements of the CVC Section 34631 (d).

that for the purposes of Risk Retention Group coverage, this policy meets the requirements of the Risk Retention Act of 1991, California Insurance Code Section 125 and following, and is authorized to do business in California.

Insurer agrees to each of the following:

that this Certificate of Insurance shall not be canceled on less than thirty (30) days notice from the Insurer to the DMV and written on a Notice of Cancellation form authorized by the DMV, and that the thirty (30) day period commences to run from the date the Notice of Cancellation form was actually received at the office of the California Department of Motor Vehicles, Motor Carrier Services Branch, in Sacramento, California.

that a duplicate original of the referenced policy, a DMV authorized endorsement, and all other related endorsements and documentation, shall be furnished to DMV upon request.

By signing this form, the Insurer certifies under penalty of perjury under the laws of the State of California that all information contained in this Certificate of Insurance is true and correct.

PRINTED NAME OF INSURER’S AUTHORIZED REPRESENTATIVE

 

 

 

TELEPHONE NUMBER

EMAIL ADDRESS

 

 

(

)

 

 

 

 

 

 

 

 

 

SIGNATURE OF INSURER’S AUTHORIZED REPRESENTATIVE

 

 

 

EXECUTED AT (CITY AND STATE)

DATE

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DMV 65 MCP (REV. 2/2005)

 

 

 

 

 

 

 

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Form Specifications

Fact Name Description
Purpose of the Form The DMV 65 MCP form serves as a Certificate of Insurance for motor carriers of property in California.
Governing Laws This form is governed by California Vehicle Code Sections 34630, 34631.5, and 34640, as well as Part 387 of Title 49 of the Code of Federal Regulations.
Insurance Coverage The form certifies that the motor carrier is covered by necessary insurance policies, including bodily injury, property damage, and workers’ compensation.
Cancellation Notice The insurer must provide a 30-day notice to the DMV before canceling the insurance, ensuring continued coverage for the motor carrier.
Endorsements Requirement An authorized endorsement must be attached to the policy to meet DMV requirements, ensuring compliance with the Motor Carriers of Property Permit Act.
Verification of Information By signing the form, the insurer certifies that all information provided is true and correct under penalty of perjury.

Dmv 65 Mcp: Usage Guidelines

Filling out the DMV 65 MCP form is an important step for motor carriers in California to ensure compliance with insurance requirements. After completing the form, it will need to be submitted to the California Department of Motor Vehicles for processing.

  1. Obtain the form: Download or print the DMV 65 MCP form from the California DMV website or acquire a physical copy from a DMV office.
  2. Fill in the date: Enter the date the form is being completed in the designated space at the top of the form.
  3. Motor Carrier Information: Provide the Motor Carrier (CA) number and the name and address of the motor carrier.
  4. Insurance Company Details: Enter the name and address of the insurer (insurance company) along with the NAIC number.
  5. Type of Insurance: Indicate the type of insurance policy being provided (e.g., primary liability, excess liability, workers’ compensation).
  6. Policy Information: Fill in the policy number, effective date, and coverage limits for bodily injury, property damage, and any other applicable coverage.
  7. Insurer Certification: Review the certification statements to ensure all conditions are met. The insurer must confirm coverage and compliance with California Vehicle Code requirements.
  8. Authorized Representative: The insurer’s authorized representative must print their name, provide a telephone number, and an email address.
  9. Signature: The authorized representative must sign and date the form, indicating that all information is accurate and complete.
  10. Review: Double-check all entries for accuracy and completeness before submitting the form.
  11. Submit the form: Send the completed form to the California Department of Motor Vehicles, Motor Carrier Services Branch, at the address provided on the form.

Your Questions, Answered

What is the DMV 65 MCP form?

The DMV 65 MCP form is a Certificate of Insurance specifically for Motor Carriers of Property in California. It is required to demonstrate that a motor carrier has the necessary insurance coverage as mandated by California law. This form must be filed with the California Department of Motor Vehicles (DMV) to ensure compliance with state regulations regarding commercial vehicle operations.

Who needs to file the DMV 65 MCP form?

Any motor carrier operating in California that requires a motor carrier permit must file the DMV 65 MCP form. This includes businesses that transport goods for hire. The form confirms that the carrier has adequate insurance coverage for bodily injury, property damage, and workers' compensation, as required by law.

What information is required on the DMV 65 MCP form?

The form requires detailed information about the motor carrier, including the name and address of the insured, the insurance company, policy number, and coverage limits. It also asks for the type of insurance being provided, such as primary liability or workers' compensation, and must include a certification from the insurer regarding the coverage's compliance with California Vehicle Code requirements.

How does one submit the DMV 65 MCP form?

The DMV 65 MCP form can be submitted by mailing it to the California Department of Motor Vehicles, Motor Carrier Services Branch. The mailing address is P.O. Box 932370, MS G875, Sacramento, CA 94232-3700. It is important to ensure that the form is complete and accurate to avoid delays in processing.

What happens if the insurance policy changes or is canceled?

If the insurance policy changes or is canceled, the insurer must notify the DMV at least thirty days in advance. This notification must be made using a Notice of Cancellation form authorized by the DMV. It is crucial to maintain continuous coverage to avoid penalties or disruptions in the motor carrier's operations.

Can the DMV 65 MCP form be filed electronically?

Common mistakes

  1. Missing Information: Failing to fill in all required fields can lead to delays. Ensure every section is complete, including the motor carrier name and address.

  2. Incorrect Dates: Entering the wrong policy effective date can cause issues. Always double-check that the date is in the correct format (MM/DD/YY).

  3. Policy Limits Errors: Providing incorrect limits for bodily injury or property damage can result in rejection. Make sure the limits meet California's statutory minimums.

  4. Omitting the Endorsement: Not attaching the required endorsement can invalidate the form. Confirm that the endorsement is included and properly executed.

  5. Inaccurate Insurance Company Information: Listing incorrect details about the insurer can lead to complications. Verify the insurer's name, address, and NAIC number.

  6. Signature Issues: Forgetting to sign the form or having an unauthorized person sign can cause problems. Ensure the authorized representative signs and dates the document.

  7. Not Notifying DMV of Cancellations: Failing to provide a 30-day notice for policy cancellations can lead to penalties. Always send the notice as required.

  8. Ignoring Coverage Requirements: Not meeting the specific coverage requirements for workers' compensation or other policies can result in rejection. Review the necessary coverage types carefully.

  9. Submitting Without a Copy: Not including a duplicate original of the insurance policy can delay processing. Keep a copy for your records and provide one to the DMV as needed.

Documents used along the form

The DMV 65 MCP form is a crucial document for motor carriers in California, serving as a Certificate of Insurance. Along with this form, several other documents are often required to ensure compliance with state regulations. Below is a list of related forms and documents that are commonly used in conjunction with the DMV 65 MCP form.

  • Notice of Cancellation Form: This document is used by insurers to notify the DMV of any cancellation of the insurance policy. It must be submitted with at least thirty days' notice.
  • Endorsement Form: An endorsement is a document that modifies the original insurance policy. It confirms that the policy meets the requirements set forth by the DMV and is necessary for compliance.
  • Motor Carrier Permit Application: This application is required for motor carriers to obtain a permit to operate legally in California. It includes information about the carrier's business and vehicle details.
  • Proof of Workers’ Compensation Insurance: This document demonstrates that the motor carrier has coverage for employees in case of work-related injuries, as mandated by California law.
  • Certificate of Good Standing: This certificate verifies that a business is registered and compliant with state regulations, ensuring that it is authorized to operate as a motor carrier.
  • Federal Motor Carrier Safety Administration (FMCSA) Registration: This registration is necessary for carriers that operate across state lines. It provides proof of compliance with federal safety regulations.
  • Vehicle Registration Documents: These documents prove that the vehicles used by the motor carrier are registered with the state. They are essential for legal operation on public roads.

These documents collectively help ensure that motor carriers meet the necessary legal requirements for operation in California. Properly managing these forms can prevent potential legal issues and ensure smooth business operations.

Similar forms

The DMV 65 MCP form is a critical document for motor carriers in California, primarily serving as a Certificate of Insurance. Several other documents share similarities with this form in terms of purpose and requirements. Here are seven such documents:

  • Certificate of Liability Insurance: This document provides proof of liability coverage for businesses, similar to the DMV 65 MCP, which certifies insurance for motor carriers.
  • Commercial Auto Insurance Policy: Like the DMV 65 MCP, this policy outlines coverage for vehicles used for business purposes, ensuring compliance with legal requirements.
  • Workers' Compensation Insurance Certificate: This certificate verifies coverage for employee injuries, paralleling the DMV 65 MCP's inclusion of workers' compensation requirements.
  • Proof of Insurance for Commercial Drivers: This document is essential for drivers to show they have the necessary coverage, akin to the DMV 65 MCP's focus on motor carrier insurance.
  • Endorsement Forms: These forms modify existing insurance policies to meet specific requirements, similar to the DMV 65 MCP's need for authorized endorsements.
  • Motor Carrier Permit Application: This application is required to operate as a motor carrier and must include proof of insurance, much like the DMV 65 MCP serves as proof of coverage.
  • Certificate of Insurance for Risk Retention Groups: This document certifies coverage for groups sharing risk, reflecting the DMV 65 MCP's provisions for risk retention group insurance.

Dos and Don'ts

When filling out the DMV 65 MCP form, it's essential to be thorough and accurate. Here’s a helpful list of things you should and shouldn't do to ensure a smooth process.

  • Do double-check all information for accuracy before submitting.
  • Do ensure that the insurance policy covers all vehicles used by the motor carrier.
  • Do attach a fully executed endorsement as required by the DMV.
  • Do provide the correct policy number and effective dates.
  • Don't leave any sections blank; incomplete forms can delay processing.
  • Don't forget to include the insurer's contact information.
  • Don't submit the form without the authorized representative's signature.
  • Don't assume that verbal confirmations from the insurer are sufficient; always have documentation.

By following these guidelines, you can help ensure that your DMV 65 MCP form is processed efficiently. Taking the time to carefully complete the form can save you from potential headaches down the line.

Misconceptions

  • Misconception 1: The DMV 65 MCP form is only necessary for large trucking companies.
  • This form is required for any motor carrier of property operating in California, regardless of the size of the business. Even small operators must comply with this requirement.

  • Misconception 2: Once the form is submitted, it does not need to be updated.
  • Changes in insurance coverage or company details necessitate an update to the DMV 65 MCP form. Keeping it current is essential to remain compliant.

  • Misconception 3: The DMV does not require proof of insurance for all vehicles.
  • The form certifies that all vehicles used by the motor carrier are covered under the insurance policy, even if they are not listed specifically in the policy.

  • Misconception 4: The DMV 65 MCP form is only relevant for liability insurance.
  • This form also pertains to workers' compensation insurance, ensuring that all necessary coverage types are addressed for motor carriers.

  • Misconception 5: Submitting the form guarantees that the insurance policy will not be canceled.
  • While the insurer must provide 30 days' notice before cancellation, it does not guarantee that the policy will remain active indefinitely.

  • Misconception 6: Any insurance company can issue the DMV 65 MCP form.
  • The insurance company must be licensed to write insurance in California and comply with specific regulations to issue this form.

  • Misconception 7: The DMV 65 MCP form is a one-time requirement.
  • Misconception 8: The DMV does not verify the information provided in the form.
  • The DMV has the authority to verify the accuracy of the information submitted. Any discrepancies can lead to penalties or the denial of permits.

Key takeaways

Here are key takeaways for filling out and using the DMV 65 MCP form:

  • Understand the Purpose: This form certifies that a motor carrier is insured according to California law.
  • Complete All Sections: Ensure every section of the form is filled out accurately, including the insurer's details and coverage limits.
  • Insurance Requirements: The form must reflect coverage that meets or exceeds statutory minimums for bodily injury and property damage.
  • Endorsements: Attach a fully executed endorsement authorized by the DMV to the insurance policy.
  • Cancellation Notice: The insurer must provide a 30-day notice to the DMV before canceling the insurance.
  • Documentation: Be prepared to provide a duplicate original of the insurance policy and any related endorsements upon DMV request.
  • Signature Requirement: The form must be signed by an authorized representative of the insurer, certifying the truth of the information.
  • Submission Location: Send the completed form to the California Department of Motor Vehicles, Motor Carrier Services Branch.