Checklist for Driver Details
DRIVING LICENCE
Any query concerning Driving Licences should be raised with the Head of Transport Fleet Services on 01629 532110 (VOIP ext 32110)Employees Name ………………………………..
Licence Type (i.e. UK1) ………………………………..
Licence No ………………………………..
Issue No ……………………………….
Issue Date ……………………………….
Last Check Date ……………………………….
Entitlements ……………………………….
If the licence holder has entitlements C or C+E record details below from their DQC (Driver Certificate of Professional Competence)
DQC No
Expiry Date
Confirm / Please Tick
§ I have seen the original documentation for the licence and paper counterpart to photocard Licence
§ Take a photocopy of both sides of licences and counterparts and append to this form
Check
§ Does the Licence contain the security markings
§ Personal details are correct – name, date of birth and address
§ Age Restrictions – Use Guide to Driving Licences
§ Restriction codes - Use Guide to Driving Licence Information and Restriction Codes
§ Photocard expiry date
§ Any new endorsements/disqualifications since last licence check if so list below – Use Guide to Driving Offences & Penalty Points
Code / Date of Conviction / Code / Date of Conviction
§ Whether any medicals/renewals are due in the future – if so advise driver
§ Advise driver of reportable medical conditions see section of this form
§ Bring to the attention of the driver the policy on the use of Mobile Telephones and Substance Misuse.
MEDICAL CONDITIONS
§ Bring the following to the attention of the employee:It is an offence for a person to drive on a road any vehicle otherwise than in accordance with a licence authorising them to drive it. It is also an offence for a person to cause or permit to cause another person to drive it.
I am aware that any changes to the medical conditions or my health which affect my ability to drive or drive safely must be reported to the Drivers Medical unit, DVLA, Swansea SA99 1TU and my line manager:
The following conditions are reportable to the DVLA:
§ Epilepsy, fits or blackouts
§ Severe and recurrent disabling giddiness
§ Parkinson’s disease
§ Any chronic neurological condition, eg multiple sclerosis, motor neurone disease
§ Major or minor strokes
§ Brain surgery, brain tumour, severe head injury
§ Memory problems
§ Any mental ill health condition (including depression)
§ Any psychiatric illness requiring hospital admission
§ Dependence on or misuse of alcohol or drugs in the past 3 years
§ Sight in one eye only or visual problem affecting either eye
§ Diabetes controlled by diet/tablets/insulin
§ Any heart condition other than innocent heart murmurs
§ Peripherals arterial disease causing symptoms
§ Abdominal aortic aneurysm
§ Sleep apnoea syndrome/narcolepsy/cataplexy
§ Any other condition which causes excessive daytime or awake time sleepiness
§ Severe spinal injuries
§ Treatment for the following types of cancer or tumours in the last 5 years, lung, melanoma, non hodgkin’s lymphoma
§ Aids
§ Behavioural problems, eg aspergers syndrome
§ Chronic renal failure
§ Deafness (profound)
§ Any other medical condition likely to affect ability to safely control a vehicle, eg amputation, impairment secondary to medication, chronic debilitating illness
VEHICLE INSURANCE
This section is to be used when checking the licence details of Grey Fleet Drivers (Casual or Essential Users)
Confirm / Please Tick§ I have seen the original documentation for the Vehicle Insurance
§ Take a photocopy of the vehicle insurance certificate and append to this form
Any query concerning Insurance should be raised with the Insurance and Risk Manager at County Hall on extension 39988 / Yes
or
No
Do you recognise the insurance provider
Does the certificate say that the insurer is authorised and regulated by the Financial Services Authority
The description and registration of the vehicle insured is the same as the one the employee is claiming mileage allowance for
Is the policy holder the employee
If No who is the policy holder and is the employee a named driver.
Is the employee covered for business purposes
Is the policy in force and has not expired
List the classes of persons entitled to drive
Any limits on use applied by the insurer
If YES what are they
Bring the following statement to be attention of the employee:
You are advised that failure to pay the premium in full will render the policy null and void and preclude you from using the vehicle on Council business.
If the Policy has one month or less before expiry ask the employee to present the new policy on issue.
VEHICLE MOT CERTIFICATE
This section is to be used when checking the licence details of Grey Fleet Drivers (Casual or Essential Users)
Confirm / Please Tick§ I have seen the original documentation for the Vehicle MOT Certificate
§ Take a photocopy of the vehicle MOT Certificate and append to this form
Any query concerning MOT Certificates should be raised with the Head of Transport Fleet Services on 01629 532110 (VOIP ext 32110) / Yes
or
No
The description and registration of the vehicle described on the Test Certificate is the same as the one the employee is claiming mileage allowance for
Was an Advisory Notice Issued (if yes ask for a copy of the advisory notice and append to this form).
Expiry Date of Certificate
Have the advisory items been rectified or replaced
If NO list the items still outstanding, if necessary seek advice from County Transport.
J:\Consulting-and-Contracting\County-Transport\Butterly_TP\Transport Admin\Forms\EN068 - Check list for Driver Details.doc EN068 Revised 01/10/11
/ DERBYSHIRE COUNTY COUNCILChecklist for Driver Details
If the MOT Certificate has one month or less before expiry ask the employee to present the new certificate on issue.
I declare that I have produced my latest licence, insurance and MOT Certificate.
(Delete items not appropriate)
Signature of Employee
Signed …………………………………………………. Date ……………………………..
Signature of Person Conducting Check
Signed …………………………………………………. Date ……………………………..
Position………………………………………………………………………….
J:\Consulting-and-Contracting\County-Transport\Butterly_TP\Transport Admin\Forms\EN068 - Check list for Driver Details.doc EN068 Revised 01/10/11