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Home My WebLink AboutCAG2018-0399 - Supplement - Regional Motorcade, LLLP - Emergency Vehicle Permit - 04/19/2019 AUTHORIZED EMERGENCY VEHICLE PERMIT M. ?� f APPLICATION DATE APPROVED: VALID UNTIL: CAPTAIN: WASHINGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BLDG PO BOX 42600 For Department Use Only) OLYMPIA WA 98504-2600 This application must be submitted by the Chief Executive of the firm or corporation making application. Please type or print in ink. Person, Company, Department, or Agency (if a person, must list agency/department representing) Regional Motorcade, LLLP Address 3211 West McGraw St, Suite#99022 City Seattle State WA Zip 98139 Phone (888)988-1723 ext 700 E-mail cowboy@regionalmotorcade.com regionalmotorcade.com 1. Purpose of Application/Authority: Describe below the specific purpose for which the vehicle(s)will be used as authorized emergency vehicle(s) and what necessitates permitting as an authorized emergency vehicle. The purpose should include the nature and scope of the duties, responsibilities, and intended uses of emergency equipment, as well as the statutes that give authority for the listed equipment and uses. The purpose and intended use of these vehicles are for funeral escorts using lights and sirens to alert the public of our approach, presence and intent to escort the funeral procession to the place of internment by the route which is both legal and practicable in accordance with WAC 308-330-466; and having equipment which has met the requirements of RCW 46.37.190 (Warning devices on vehicles) facilitates requesting other vehicles to yield the right-of-way and immediately drive to a position parallel to, and as close as possible to, the right-hand edge or curb of the roadway clear of any intersection and stop and remain in such position until the authorized emergency vehicle has passed in accordance with RCW 46.61.210. The purpose of this application is for the safety of pedestrians, other vehicles, procession participants and escort vehicle operators. The nature of the duties and responsibilities of each operator extend only to the safety of the procession in compliance with law and jurisdictional restrictions and does not relieve the operator of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons using the roadways. 3000-323-006(R 8/15) Page 1 of 7 AUTHORIZED EMERGENCY VEHICLE PERMIT Ia®i* LA APPLICATION 2. Vehicle Information: List all vehicles intended to be used as authorized emergency vehicles. For each vehicle, provide all vehicle and emergency equipment information as outlined below. Prior approval must be given before utilizing a new vehicle or a vehicle with equipment installed other than what is authorized under the current permit for that vehicle. Proof of insurance for each vehicle must be attached pursuant to WAG 204-36-030. If providing funeral escorts, proof of commercial insurance in Washington State or business use exemption must be provided pursuant to WAC 204-36-040. VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2019 9339LEM ®SIREN BMW K52SF MAKE MODEL ®LAMP(s) (location/Colors) BMW R1250RT-P Front,S ides,Rear/Red Code 3 LEDX VIN Front,Sides/White Code 3 TSX3 WB1011309KZG34059 REGISTERED OWNER DOTHER EQUIPMENT Paul W. Fison VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2013 9344LEM ®SIREN Code 3 R120ORTP MAKE MODEL ®LAMP(s) (location/Colors) BMW R120ORT-P Front,S ides,Rear/Red Code 3 TSX3 2' VIN Front/White Code 3 LTD-901 WB1044003DZW22005 Sides/White Code 3 XT3 REGISTERED OWNER ®OTHER EQUIPMENT Paul W. Fison Rear Pole Light/Red Redtronic EM403 VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2009 9371LEM ®SIREN Code 3 R120ORTP MAKE MODEL ®LAMP(s) (location/Colors) BMW R120ORT-P Front,Sides,Rear/Red Code 3 TSX3 3' VIN Front/White Code 3 LTD-901 WB10388029ZT15446 Sides/White Code 3 XT3 REGISTERED OWNER ®OTHER EQUIPMENT Thomas Chizwell Rear Pole Light/Red Redtronic EM403 VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2003 8E8144 ®SIREN Code 3 R1150RTP MAKE MODEL ®LAMP(s) (location/Colors) BMW R1150RT-P Front,Sides, Rear/Red Code 3 LEDX 4' VIN Sides/Red Redtronic BX31 WB 10499A63ZE89539 REGISTERED OWNER ®OTHER EQUIPMENT Regional Motorcade, LLLP Rear Pole Light/Red Redtronic EM403 3000-323-006(R 8/15) Page 2 of 7 AUTHORIZED EMERGENCY VEHICLE PERMIT ': MVOTE Wf APPLICATION 2. Vehicle Information (continued): VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2013 LEM9718 ®SIREN Whelen WS321 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red/White Whelen PAR-36 5. VIN Front Forks/Red/White Star Signal DLXT IHDIFMM15DB651436 Radio Box/Red/White Whelen 500 REGISTERED OWNER Radio Box/Red Redtronic BX62 Albert Mitchell MOTHER EQUIPMENT Array/Red/White Whelen M04Z VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2013 LEM9525 ®SIREN Whelen WS321 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 6. VIN Bags,Fender/Red/White Whelen LINZ6/TIR3 IHDIFMM14DB645837 Radio Box/Red/White Whelen TIR6/500 REGISTERED OWNER Radio Box/Red Redtronic BX62 Douglas Morgan MOTHER EQUIPMENT Array/Red/White Whelen MO1LD VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2014 7C6153 MSIREN Whelen WPA112 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 7. VIN Radio Box/Red/White Whelen Dual LED 1 HD 1 FMM 13EB616413 REGISTERED OWNER Patric Kelly ❑OTHER EQUIPMENT VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2014 LEM9696 MSIREN Whelen WPA112 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 8. VIN Crashbar/Red Whelen LIN6 1HDIFMMIXEB619695 Radio Box/Red/White Whelen 400 Dual LED REGISTERED OWNER Radio Box/Red Redtronic TIR6 Thomas Chiswell MOTHER EQUIPMENT Array/Red/White Whelen MO1LD 3000-323-006(R 8/15) Page 3 of 7 AUTHORIZED EMERGENCY VEHICLE PERMITUIr IT- APPLICATION 2. Vehicle Information (Continued) VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2011 LEM9525 ®SIREN Whelen WS320 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 9, VIN Radio Box/Red 911 Signal E3 IHDIFMM14DB645837 REGISTERED OWNER Regional Motorcade, LLLP ❑OTHER EQUIPMENT VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2019 7F2690 ®SIREN Whelen WS321 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 10. VIN Side/Red/White Feniex Wide Lux 7x3E3 1 HD 1 FMP 14KB63 8427 Front/Rear/Red Whelen Linz 3 REGISTERED OWNER Rear/Red Whelen M7 Dave Wyatt ❑OTHER EQUIPMENT VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2012 9455LEM ®SIREN Whelen SA315P MAKE MODEL MLAMP(s) (location/Colors) HONDA ST1300P Front/Red Whelen M6 11. VIN Front,Rear,Sides/Red Whelen Linz 6 JH2SC5158CK000139 Front,Rear,Sides/White Whelen Linz 6 REGISTERED OWNER Front/Red Whelen VTX609R Richard Fisher ❑OTHER EQUIPMENT VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION YEAR LICENSE NO. INSTALLED MAKE MODEL 2009 OF9695 MSIREN Whelen WS320 MAKE MODEL MLAMP(s) (location/Colors) H/D FLHTP Front/Red Whelen PAR-36 12. VIN Sides/Red Whelen TIE 6 1 HD 1 FMM 169Y607126 Rear/Red/White Whelen LIN2 REGISTERED OWNER Forrest Huiatt ❑OTHER EQUIPMENT 3000-323-006(R 8/15) Page 4 of 7 AUTHORIZED EMERGENCY VEHICLE PERMIT °°` .,hT APPLICATION I'_ 3. Operators:Please list all drivers that will be authorized to operate the vehicle(s) listed in this application and indicate whether or not the operator/driver is new since your last application by placing an X in the"New?" column; otherwise, leave this column blank. No drivers should be listed unless they have been approved. Per WAC 204-36-040, all operators involved in traffic control must be a Washington State certified flagger, and carry their certified flagger card at all times. i Name Driver's License Number Flagger Certification Number New? (if applicable—see WAG 204.36-040) Albert Mitchell WDL6SNSFC63 312561 Thomas Chiswell CHISWTJ456NM 312562 Douglas E Morgan MORGADE397QP 312563 Paul Fison FISONPW429NA 363988 Patric Kelly KELLYPB471MB 312565 David Wyatt WDL2SNB3113B 373347 Larry Abraham ABRAHLH358N1 420423 Yes Darren Thackeray THACKD*400LS Training scheduled Yes Donald F Huiatt HUTATFD487M4 386023 Yes Nick Ehli EHLI*N*441KR 334244 Yes Richard Fisher FISHERW495BZ :386006 Yes 3000-323-006(R 6/15) Page 5 of 7 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION _ , 4. Geographic Area: Indicate which types of roads and which specific geographic area(s)the authorized emergency vehicles will be used. Certification from each jurisdiction is required under WAC 204-36-030. Certification is covered in section 6 of this application. ❑x City Streets (list all cities) - Kent ❑ County Roads (list all counties)- ❑ State Routes/Interstates (list all state routes, interstates, and counties) - 5. Permit Validation: I certify(or declare) under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct to the best of my knowledge, information, and belief, and that: a. All of the information given in this application is correct to the best of my knowledge and provided in its full format to the undersigned chief law enforcement officer or fire chief(if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). b. None of the drivers,to the best of my knowledge, in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender. C. Only the vehicle(s)and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for any purpose not authorized under this permit unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. If I wish to add a new driver or vehicle to this permit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminal or civil liability as well as cancellation of this permit as outlined under chapter 204-36 WAC. In addition, I understand that it is my responsibility to ensure that a copy of this permit listing all approved drivers and geographic areas authorized, as well as a copy of the vehicle permit authorizing emergency equipment is present in each vehicle at all times and must be presented to law enforcement, if requested. Z Signature '��..i Title President (CHIEF EXECUTIVE OFFICER) Name Albert Mitchell Date 04/01/2019 (TYPE OR PRINT) 3000-323-006(R 8/15) Page 6 of 7 AUTHORIZED EMERGENCY VEHICLE PERMIT .Xam w APPLICATION _ ?r 6. Certification: This application for an Authorized Emergency Vehicle Permit will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief(if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicle(s) are to be used as authorized emergency vehicles (see part 4 of this application). If the application is made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must include the following language: "I hereby certify that I have reviewed this entire application; that I am aware that the applicant intends to use the vehicle(s) and emergency equipment listed in part 2 of this application, for the specific purposes listed in part 1 of this application; that a need exists in my jurisdiction for the listed vehicle(s)to be used as authorized emergency vehicles and that the applicant has the appropriate authority as described in part 1 of this application to operate such equipment; and I know of no reason why this application should be denied." Please type or print: Signature Date Oq_lf- Title Name(Please Print) 4e, Jurisdiction Phone E-Mail Restrictions Signature Date _ Title Name (Please Print) Jurisdiction Phone _( ) E-Mail Restrictions Signature Date Title Name (Please Print) Jurisdiction Phone ( ) E-Mail Restrictions Signature Date Title Name Jurisdiction (Please Print) Phone ) E-Mail Restrictions Signature Date Title Name (Please Print) Jurisdiction _ Phone ( ) E-Mail Restrictions Signature _ Date _ Title Name (Please Print) Jurisdiction Phone ( ) E-Mail Restrictions Note: This page may be copied if additional certifications need to be added to the permit. Any additional sheets attached must provide the certification information in the same format as above. 3000-323-006(R 8115) Page 7 of 7 Registration Certificate Model Year Make Model Body Style ;Vehicle identification number(VJN) Scale Weight 2009 HD FLHTP Touring 1HD1FMM169Y607126 794 Plate/Tag no Tab/Decal no Primary vehicle use type Issue date Exp date t OF9695 C174373 (Motorcycle 06/11/2018 08/25/2019 PlatelTag no TablDecal No 'Vehicle use type Issue date Exp date ' ) Gross Weight I Gr wt start date Gross weight exp date Fleet no Equip no � Y Registered Owner Legal Owner HUTATT, FORREST TAPCO CREDIT UNION PO BOX 497 6312 19TH ST W OLALLA WA 98359-0497 FIRCREST WA 98466-6226 Brands/Comments: 1539712008.BLACK-WHITE,WA Former Exempt Anyone who knowingly makes a false statement may be guilty of a felony under state aw and upon conviction shall be punished by a fine, imprisonment, or both. /certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct and, as owner or authorized agent of the vehicle, it is free of any claim of lien, mortgage, conditional sale or other security interest of any person except the person or persons set forth as legal owners. X X Signature of registered owner Signature of registered owner Date and place signed Date and place signed L0038192497 Vehicle Information: OF9695 1 HD1 FMM169Y607126 2009 HD FLHTP Touring Filing Registration Filing $3.00 Registration Dept.of Licensing Service $0.50 License Plate Technology $0.25 Vehicle Weight $25.00 Registration License $30.00 Service Registration Service Fee $5.00 C Fee Total: $63.75 Issue Date: 06/11/2018 You can get a copy of this cash/fee receipt detail at www.dol.wa.gov, Skip a trip—go online www.dol.wa.gov