4821 Bethlehem Road, Suite 101
Richmond, VA 23230
Phone: (804) 355-5371 ♦ Fax: (804) 358-1374
E-mail:
VTA Fleet Safety Contest
Annual Report Form
Entry Deadline is February 9. Complete using fleet safety data for calendar year 2017.
Reporting requirements for the VTA Fleet Safety Contest:
1.A separate report must be filed for each major division representing a type of service performed within the state.
2.Statistics and rates must be listed for state-wide not system-wide operations. Frequency rates shall be expressed in terms of the number of accidents per 1 million miles as determined by the following formula:
Frequency =Number of Accidents X 1,000,000
Total Mileage
Name of Company
Address
Safety Director
Contest Division - Check () one. A separate report must be filed for each Division entered. All Divisions must have a minimum of five participants before the Division will be judged in the contest. Contestants will be notified if their Division has less than five entries.
GENERAL COMMODITIES – TRUCKLOAD HEAVY HAULERS
GENERAL COMMODITIES - LTLPRIVATE CARRIERS
TANK TRUCKAUTO TRANSPORTERS
HOUSEHOLD GOODSBULK/DUMP TRUCK
MISCELLANEOUS (Specify)
Total Accidents / Total Mileage / 2017 Frequency Ratio / 2016 Frequency RatioCOMBINED
INTERCITY
LOCAL
The following certification must be signed by an officer of the company other than the Safety Director.
We hereby certify that the information submitted above is correct to the best of our knowledge and belief. We agree that a check of the record may be made prior to the announcement of any award to this organization.
______(Signature) (Title)
Virginia Trucking Association
4821 Bethlehem Road, Suite 101
Richmond, VA 23230
Phone: (804) 355-5371 ♦ Fax: (804) 358-1374
E-mail:
VTA FLEET SAFETY CONTEST RULES
For Calendar Year 2017
Section 1 - ELIGIBILITY
1.1All fleet members of the Virginia Trucking Association are eligible for entry in the contest for the Safety Awards.
Section 2 - REPORTING OF MILEAGE AND ACCIDENTS
2.1The contest shall be on a calendar year basis.
2.2Report requirements:
a.Reports shall be made for the total annual Virginia mileage of the entire fleet.
b.Fleets are to report DOT recordable accidents that occur in the Commonwealth of Virginia. This means that accidents meeting the definition contained in Part 390.5 of the Federal Motor Carrier Safety Regulations are to be reported on the entry form for the 2017 VTA Fleet Safety Awards contest.
Part 390.05 provides that:
Accidentmeans -
(1) Except as provided in paragraph (2) of this definition, an occurrence involving a commercial motor vehicle operating on a highway in interstate or intrastate commerce which results in:
(i) A fatality;
(ii) Bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene of the accident; or
(iii) One or more motor vehicles incurring disabling damage as a result of the accident, requiring the motor vehicle(s) to be transported away from the scene by a tow truck or other motor vehicle.
(2) The term accident does not include:
(i) An occurrence involving only boarding and alighting from a stationary motor vehicle; or
(ii) An occurrence involving only the loading or unloading of cargo.
2.3All applicable information must be recorded on the report form attached. In the event a contestant's drivers have had no accidents during the year, the words "No Accident" must be inserted in the accident column of the report.
2.4Reporting deadline. All entries must be received in the VTA office no later than February 9, 2018.
Section 3 - GRAND TROPHY REQUIREMENTS
3.1 Eligibility for Grand Trophy competition will be limited to those entrants meeting the following qualifications:
a.Entered motor carrier fleet safety contest and been judged a first place winner in a class of mileage competition.
b.Supplied information for the past twelve months of the reporting period regarding accident records of its Virginia-based drivers.
c.Completed Parts II and III of the Grand Trophy Contest Entry Form.