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Get IN M-203 2016-2024

Form M-203 State Form 25415 R5 / 7-11 Indiana Department of Revenue Oversized/Overweight Transporting Company Agreement This application is made and offered 20 to and between the State of Indiana acting by and through the Indiana Department of Revenue hereinafter referred to as the State and Legal Company Name Hereinafter referred to as the Transporting Company. Doing Business As if applicable Company Type ex. Corporation etc* Physical Address Mailing Address Include City State Zip and County Federal Identification Number Social Security Number if sole proprietor US DOT Number If the vehicle has a gross vehicle weight or gross combined vehicle weight of 10 001 lbs. or more. Federal Motor Carrier MC Number A company that provides truck transportation of cargo belonging to others and is paid for doing so is required to obtain an MC number to operate as an interstate for-hire carrier. 1. Request a permit for all oversize and/or overweight vehicular movements. 2. Indemnify defend exculpate and hold harmless the State its officials and employees from any liability due to loss damage injuries or other casualties of whatsoever kind or by whomsoever caused to the person or property of anyone on or off the right-of-way arising out of or resulting from the issuance of permits as herein provided or the work connected herewith or from the installation existence use maintenance condition repairs alterations or removal of any equipment or material whether due in whole or in part to the negligent acts or omissions 1 of the State its officials agents or employees or 2 of the Transporting Company its agents or employees or other persons engaged in the performance of the work or 3 the joint negligence of any of them including any claims arising out of the Workmen s Compensation Act or any other law ordinance order or decree. The Transporting Company also agrees to pay all reasonable expenses and attorney s fees incurred by or imposed on the State in connection herewith in the event that the Transporting Company shall default under the provisions of this paragraph. 3. Have valid insurance coverage on the vehicle for at least the minimum value required by the statutes of the State. The insurance must be valid for the time this agreement is in force. 4. Be responsible for the validity of all checks and instruments used in the payment of permit fees which must be paid as required* 5. Agree to the recording of all telephone conversations for the purpose of ordering and issuing permits. 6. Order future permits by using the Company Number. The number will be used to identify the Transporting Company. 7. Use only the permit application forms which will be prescribed by the State. 8. If a permit must be sent to a driver Form M-233 or other Department approved form must be completed and sent in a format and by a method previously approved by the State. 9. Use only the State s telephone lines to call in permit application data* 10. Certify that the permit form will be completed properly including the starting and expiration date describing accurately the truck when loaded with the object to be hauled giving the origin of the load the destination of the load and only the state routes by title and number which will be used to move the load* 11.

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