National Safety Code

Safety Certificate Application

Application Number 2012018006

Start
1. I am applying:

SOLE APPLICANT

SOLE APPLICANT
3a. Surname
SAHI

Given Names
HARVINDER
SINGH
Other Safety Certificates : Yes
Certificate Number
079959450
Certificate Number
2012028482

3b. DL Number
7995945

DL Jurisdiction
BRITISH
COLUMBIA

Certificate Jurisdiction
BRITISH COLUMBIA
Certificate Jurisdiction
BRITISH COLUMBIA

3c. Date Of Birth

1980-Sep-16

3d. Title

3e. Driver?
Y

Name on Certificate
HARVINDER SINGH SAHI
Name on Certificate
HARVINDER SINGH SAHI

5. Doing Business As
List all the names in which you or organization do business as or Partnership Name
HARVINDER SINGH SAHI

Contact Information
6. Business Mailing Address:
13133 64 AVE
SURREY, BRITISH COLUMBIA, CANADA
V3W1X8
Office Number
Cell Number
Fax Number
Business Email

7. Location of Business Records:

13133 64 AVE
SURREY, BRITISH COLUMBIA, CANADA
V3W1X8
(604) 597-0993
(604) 339-3807
sahicontracting@hotmail.com

8. Drivers
Surname
SAHI

Given Names
HARVINDER SINGH

DL Number
7995945

DL Jurisdiction
BRITISH COLUMBIA

DOB
1980-Sep-16

Other
0
0
Trailer
0
0

Other
0
0

Service Types
9. Where do you plan to operate
10. Are any of your services for hire?

Within BC
N

11. Transportation Services

11a. Passenger Services
11b. Non-Passenger Services
NON-PASSENGER DUMP TRUCK

12. Vehicle Inventory

12a. Passenger
Owned
Leased
12b. Non Passenger
Owned
Leased

Taxi / Limousines
0
0
Truck
0
0

Buses
0
0
Tractors
1
0

13. Vehicle Registration

Year

Make

GVW

Regi Number

Jurisdiction

1998

KENWORTH

48000

05352993

BRITISH
COLUMBIA

Last 6 digits of
VIN / Serial
Number
954048

Seating Capacity
(buses only)
0

14. Safety Profile - Drivers

Question
1. Do you have a procedure for obtaining driver abstracts?
Do you have a policy for the review of the driver abstracts?
2. Do you have a written policy requiring drivers to report
driving violations, convictions and accident details to you
within 15 days of the offence, conviction or occurrence?
3. Do you have a system to record driving violations,
convictions, and accidents for each driver that will be
operating under your safety certificate?
4. Do you have a monitoring process to ensure that drivers
supply you with all required records?

Answer
Y

Exemption

Person Responsible - Drivers

Surname
SAHI

Given Names
HARVINDER
SINGH

DL Number
7995945

DL Jurisdiction
BRITISH
COLUMBIA

DOB
1980-Sep-16

Job Title

DOB
1980-Sep-16

Job Title

DOB
1980-Sep-16

Job Title

15. Safety Profile - Vehicles

Question
Answer
1. Do you have a written schedule for each vehicle type for
Y
your maintenance program? ( this plan will include any
owner/operator working for you).
2. Do you have check sheets that will be used to support the
Y
maintenance schedules?
3. Do you have a monitoring system to ensure that your
Y
scheduled maintenance program requirements are being
met?
4. Do you have a monitoring system to ensure that all CVIP
Y
Inspections are being performed on all vehicles as
required?
5. All commercial vehicles must be trip inspected. Do you
Y
have a monitoring system to ensure that this occurs and
that any reported defects are corrected?
6. Do you have a monitoring process in place to ensure that
Y
all records of maintenance, repairs and inspection reports
are filed and retained as required and retained in individual
vehicle files?

Exemption

Person Responsible - Vehicles

Surname
SAHI

Given Names
HARVINDER
SINGH

DL Number
7995945

DL Jurisdiction
BRITISH
COLUMBIA

16. Safety Profile - Hours Of Service

Question
Answer
1. Do you have a written policy which is shared with your
Y
drivers stating that all drivers operating under your safety
certificate must operate within the hours of service permitted
by regulations?
2. Do you have a method of ensuring that drivers are aware
Y
of and operate within the hours of service permitted by
regulations?
3. Do you have a monitoring system to ensure that drivers
Y
provide you with properly completed logs or accurate time
records and all supporting documents as required?
4. Do you have a monitoring and record-keeping system to
Y
track hours of service for drivers?
5. Do you have a system to ensure that hours of service
Y
records are kept for at least 6 months in separate files for
each driver?

Exemption

Person Responsible - Hours Of Service

Surname
SAHI

Given Names
HARVINDER
SINGH

DL Number
7995945

DL Jurisdiction
BRITISH
COLUMBIA

Declaration
18. Overall Responsibility
Surname
SAHI

Given Names
HARVINDER
SINGH

DL Number
7995945

DL Jurisdiction
BRITISH
COLUMBIA

DOB
1980-Sep-16

Job Title

DL Jurisdiction
DOB
BRITISH
1980-Sep-16
COLUMBIA
Email
sahicontracting@hotmail.com

Job Title

Business Legal Name

19. Individual Submitting this form

Surname
SAHI
Office Phone
(604) 597-0993
YES
YES
YES

YES

Given Names
HARVINDER
SINGH
Cell Number
(604) 339-3807

DL Number
7995945
Fax Number

I declare that neither the applicant, nor any principal, director, officer, or partner of the applicant have had an NSC
certificate in BC or any other province, territory or state, that has been deemed unsatisfactory.
I declare that the information I have supplied in all parts of these forms is true and to the best of my ability is complete
and accurate.
I declare that I am knowledgeable in the rules and regulations governing commercial vehicle transport in British
Columbia and that I understand my obligations under the National Safety Code. I further declare that I am committed
to executing my carrier business in compliance and accordance with these rules, standards and regulations.
I Accept

Supporting Documents
Random written safety plans or oral knowledge test of National Safety Code may also be required.