21 NCAC 34B .0808          TRANSPORTION sERVICE PERMIT RENEWAL APPLICATION FORM

(a)  To renew a Transportation Service Permit, the permit holder shall complete and submit to the Board a renewal application on or before February 1 of each calendar year.

(b)  The renewal application shall contain the following:

(1)           The applicant's full name and Transporter Permit number, if one exists;

(2)           The applicant's email address, physical address, mailing address, and phone number(s);

(3)           The name of the individual or entity that owns the Transportation Service;

(4)           Whether the entity or individual owning the unaffiliated practice is a sole proprietorship, partnership, corporation, or limited liability company;

(5)           If the applicant will conduct business in a different name than that of its owning entity, a copy of the applicant's Certificate of Assumed Name;

(6)           The names and respective ownership interest percentages of each sole proprietor, partner, LLC members, or corporate officers;

(7)           A copy of valid driver's licenses issued by the State for all licensees who will be working for the Transportation Service and not previously provided to the Board by the Transportation Service;

(8)           The address of the location at which Transportation Service business records will be held;

(9)           The make, model, year, and license plate number of all removal vehicles to be used by the Transportation Service and a copy of all liability insurance required for the registration of the removal vehicles to be used by the Transportation Service;

(10)         The names, license or permit type, and license or permit number of each licensees working for the Transportation Service and whether said licensees is working on a full-time, part-time, or per case basis;

(11)         A copy of the professional liability insurance covering the acts and omissions of all Licensees engaged in Removal or Transportation on behalf of the Transportation Service, with liability limits not less than required by G.S. 90-210.25(c)(7);

(12)         Whether the applicant currently is in good standing with the North Carolina Secretary of State and, if so, documentation to establish proof of the same;

(13)         Whether the owner, partner, manager, member, operator, or officer of the Transportation Service has been convicted of any felony or misdemeanor crimes since the last year's renewal application and, if so, a statement providing the jurisdiction, charge, and disposition of each conviction;

(14)         Whether the Transportation Service or any of its owners, partners, managers, members, operators, or officers has had an occupational or business license denied, suspended, or revoked by any local, state, or federal agency since the last year's renewal and, if so, a statement providing the reason for the denial and the date, location, and circumstances of any violation that led to action against the applicant, the terms of any discipline imposed by the licensing authority, and whether said terms have been satisfied;

(15)         Whether OCME ever has terminated the ability of the Transportation Service or any of its owners, partners, managers, members, operators, or officers to provide removal or transportation services on behalf of OCME since the last year's renewal application and, if so, the reasons for said termination, if known;

(16)         Whether, within the last year's renewal application, the applicant has been the subject of any investigation for employee misclassification and, if so, the results of the investigation;

(17)         The notarized signature of the majority owner of the Transportation Service to certify that:

(A)          he or she has prepared the application and has read the answers;

(B)          the information provided in the application is true;

(C)          he or she has read and understands the public notice statement on employee misclassification that is set forth in the application and has disclosed any investigations for employee misclassification, and its results, since the last year's renewal application, as prescribed by G.S. 143-789;

(D)          he or she understands that any credential issued shall be governed by the provisions of Article 13A, Chapter 90 of the North Carolina General Statutes and the rules promulgated by the Board; and

(E)           he or she has read and understands the statutes and rules relating to the removal or transportation found in G.S. 90-210.25(c) and Section .0800 of this Subchapter, as well as the standards of OSHA for universal precautions and blood-borne pathogens found in 29 C.F.R. 1910.1030.

(18)         The signature of each owner, partner, manager, member, operator, and officer of the business entity applying to renew the Transportation Service Permit, consenting to the Board's ability to conduct a background check on his or her criminal history; and

(19)         The application fee, as prescribed by G.S. 90-210.25(c)(8) and 21 NCAC 34A .0201. If the application fee is dishonored by the drawee bank for any reason, the Board shall suspend the Transportation Service Permit until the renewal fees and non-sufficient fund charges are paid.

History Note:        Authority G.S. 90-210.23(a); 90-210.25(a)(5)(h); 90-210.25(c)(8) and (10);

Temporary Adoption Eff. November 7, 2025.