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<br />OMB No. 2126-0013 <br /> <br />U.S Department ofTransportalion <br />Federal Motor Carrier <br />Safety Administration <br />REASON FOR FILING (Check Only One) <br /> <br />o NEW APPLICATION 29 BIENNIAL UPDATE OR CHANGES <br /> <br />'i;,;',p.;,t <br />MOTOR CARRIERIDENJIFICATION REPORT <br />(Application~forf U.5 .,601. N UMBER) <br /> <br />o OUT OF BUSINESS NOTIFICATION <br /> <br />D REAPPLICATION (AFTER REVOCATION OF NEW ENTRANT) <br /> <br />11-: Nf<M" U'" MU'l'UK c;AKK1"K 2. TRADE OR D.B.A. (DOING BUSINESS AS) NAME <br />AMERICAN COACH LINES OF MIAMIINC <br />3. PRINCIPAL STREET ADDRESS/ROUTE NUMBER 4. CITY 5. MAILING ADDRESS (P 0 BOX) 6. MAILING CITY <br /> 3595 NW 110 STREET MIAMI 3595 NW 110 STREET MIAMI <br />7. STATE/PROVINCE 18. ZIP CODE + 4 9.COLONIA (MEXICO ONLY) 10. STATE/PROVINCE 11. ZIP CODE+4 r~.COLONIA (MEXICO ONLY) <br /> FLORIDA 33167 FLORIDA 33167 <br />13. PRINCIPAL BUSINESS PHONE NUMBER 14. PRINCIPAL CONTACT CELLULAR PHONE NUMBER 15. PRINCIPAL BUSINESS FAX NUMBER <br /> (305) 688-7700 (786) 367-9815 (305) 681-8134 <br />16. USDOT NO. 117. MC OR MX NO. 18. DUN & BRADSTREET NO. 19. IRSfTAX ID NO. O. INTERNET E-MAIL ADDRESS <br /> 1203231 MC476678 EIN# 200187867 SSN# harold.young@coachamerlca.com <br />21. COMPANY OPERATION (Circle all that apply) <br /> o Interstate Carrier B. Intrastate Hazmat Carrier C. Intrastate Non-Hazmat Carrier D, Interstate Shipper E. Intrastate Shipper F. Vehicle Registrant Only <br />22. CARRIER MILEAGE (to nearest 10,000 miles for Last Calendar Year) YEAR <br /> 4836619 2010 <br />23. OPERATION CLASSIFICATION (Circie All that Apply) <br />@ Authorized For-Hire D. Private Passengers (Business) G. U. S. Mail J. Local Government <br />B. Exempt For-Hire E. Private Passengers (Non-Business) H, Federal Government K. Indian Tribe <br />C. Private Property F. Migrant I. State Government L. Other <br />24. CARGO CLASSIFICATIONS (Circle All that Apply) <br />A. GENERAL F. LOGS, POLES, J. FRESH PRODUCE P. GRAIN. FEED. HAY V. COMMODITIES DRY BULK BB. CONSTRUCTION <br /> FREIGHT BEAMS, LUMBER <br />B. HOUSEHOLD G. BUILDING K. LIQUIDS/GASES Q. COAL/COKE W. REFRIGERATED FOOO CC. WATER WELL <br /> GOOOS MATERIALS L. INTERMODAL CONT. R. MEAT X. BEVERAGES DO. OTHER <br />C. METAL; SHEETS; H. MOBILE HOMES Q PASSENGERS <br /> COILS; ROLLS S. GARBAGE.REFUSE,TRASH Y. PAPER PRODUCTS <br /> I. MACHINERY, <br />D. MOTOR VEHICLES LARGE OBJECTS N. OIL FIELD EQUIPMENT T. U.S. MAIL Z. UTILITY <br />E. DRIVE O. LIVESTOCK U. CHEMICALS M. FARM SUPPLIES <br /> AWAYrTOWAWAY <br />25. HAZARDOUS MATERIALS CARRIED OR SHIPPED (Circle All that Apply) C-CARRIED S-SHIPPED B(BULK) -IN CARGO TANKS NB(NON-BULK) -IN PACKAGE <br /> C S A. DIV1.l B NB C S K, DIV 2.2A (Ammonia) B NB C S U. DIV 4.2 B NB C S EE. HRCQ B NB <br /> C S B. DIV 1.2 B NB C S L DIV 2.3A B NB C S V. DIV 4.3 B NB C S FF. CLASS 8 B NB <br /> C S C. DIV 1.3 B NB C S M. DIV 2.3B B NB C S W. DIV 5.1 B NB C S GG. CLASS 8A B NB <br /> C S D. DIV 1.4 B NB C S N. DIV 2.3C B NB C S X. DIV 5.2 B NB C S HH. CLASS 8B B NB <br /> C S E. DIV 1.5 B NB C S O. DIV 2.3D B NB C S y, DIV 6.2 B NB C S II. CLASS 9 B NB <br /> C S F, DIV 1.6 B NB C S P. Class 3 B NB C S Z. DIV 6.1A B NB C S JJ. ELEVATED TEMP MAT. B NB <br /> C S G, DIV2.1 B NB C S Q. Class 3A B NB C S AA. DIV 6.1B B NB C S KK. INFECTIOUS WASTE B NB <br /> C S H. DIV 2.1 LPG B NB C S R. Class 3B B NB C S BB. DIV 6.1 Poison B NB C S LL. MARINE POLLUTANTS B NB <br /> C S I. DIV 2.1 (Methane)B NB C S S. COM L1Q B NB C S CC. DIV 6.1 SOLID B NB C S MM. HAZARDOUS SUB(RQ) B NB <br /> C S J. DIV 2.2 B NB C S T. DIV4.1 B NB C S DO. CLASS 7 B NB C S NN. HAZARDOUS WASTE B NB <br />!26.NuMBIOROl'\7ffiJCLES THAT CAN BE OpfR7\iED IN THE\]. C S 00. ORM B NB <br /> Hazmat Cargo Motor School Bus Mini-bus Van Limousine <br /> Straight Truck Trailers Hazmat <br /> Trucks Tractors Cargo Tank Trailers Coach Number of vehicles carrying number of passengers (including the driver) below <br /> Tank Trucks 1-8 9-15 16+ 16+ 1-8 9-15 1-8 9-15 16+ <br />OWNED 101 3 <br />TERM LEASED <br />TRIP LEASED <br />27. DRIVER INFORMATION I INTERSTATE INTRASTATE I TOTAL DRIVERS TOTAL CDL DRIVERS <br /> Within 100-Mile Radius I ~ ~ 144 144' <br /> Beyond 1 OO-Mile Radius I 1441 ~ <br />28. IS YOUR U.S. DOT NUMBER REGISTRATION CURRENTLV REVOKED BV THE FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION? Yes_ No~ <br /> If Ve.. enter your U.S. DOT Number. <br />29. PLEASE ENTER NAME(S) OF SOLE PROPRIETOR(S). OFFICERS OR PARTNERS AND TITLES (e.g. PRESIDENT, TREASURER, GENERAL PARTNER. LIMITED PARTNER) <br /> 1. BRET BRITTENUM, V.P. & GENERAL MANAGER 2 . ROB FINKE. REGIONAu VICE PRESIDENT <br /> (Please print Name) (Please print Name) <br />30. CERTIFICATION STATEMENT (to be completed by an authorized official) <br /> I HAROLD YOUNG , certify that I am familiar with Ihe Federal Motor Carriar Safety Regulations and/or Federal Hazardous Materials RegUlations. <br /> (Please print Name) Under penalties of perjury. I declare that the information entered on this report is, to the best of my knowledge and belief, true, <br /> correct, and complete. <br /> Signature HAROLD YOUNG Date 05/19/2011 DIRECTOR OF SAFETY <br /> Title <br /> <br />Form MCS-150 (Rev. 3-24-2005) <br /> <br />Expiration Date: 03/31/2011 <br />