* - fields are Mandatory
Statement of Responsibility
As a NMvanpools Driver, I recognize that I must: have a valid driver’s license;
be medically fit at all times to operate a NMvanpools vehicle; comply with all requirements
set forth by the Public Regulatory Commission for drivers of non-profit commuter
vanpools; comply with NMvanpools ByLaws and Policies and Procedures and maintenance
requirements; and, comply with state, local, and federal driving laws. By my signature
below, I affirm that I have no medical condition which could impair my ability to
safely drive a NMvanpools van and that I am not taking medication (prescription
or nonprescription) which could impair my driving ability. I agree to report any
accident, bodily injury, or property damage involving the vanpool vehicle promptly
to the NMvanpools office and obtain copies of any and all reports regarding any
damage to the NMvanpools vehicle or bodily injury to a member of NMvanpools. Further,
by my signature below, I authorize NMvanpools to have my driving record checked
at any time during the period I am a NMvanpools driver. I agree to immediately notify
the NMvanpools office if given any moving violation citation of any kind whether
received in a NMvanpools van or in my personal vehicle. I know that I am not authorized
to drive any NMvanpools van until my Van Coordinator has been notified in writing
of my approval and inclusion on NMvanpools insurance policy.