UTA Vanpool Program Vanpool Participant Agreement UTA Vanpool Program Terms and Conditions

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1 Terms and Conditions Section A: All Participants Participants in the, which includes any person riding in or driving a van, agree to comply with the following terms and conditions in consideration for participating in the : 1. Participants will abide by the policies and rules set forth in the Vanpool Program Manual provided by UTA Vanpool. Participants acknowledge that UTA Vanpool may revise its policies and rules at any time its sole discretion and agree to comply with all policies as revised. 2. Participants will pay their monthly Vanpool fares prospectively either online with notice to the Bookkeeper or directly to the Bookkeeper by the fifth of the month in which they participate. 3. Participants will abide by all day-to-day operational rules of Vanpools as established by majority vote of the Vanpool members or by UTA Vanpool. 4. Participants will keep the van clean. 5. Participants will notify Drivers in advance of all absences. 6. Participants will find alternate transportation outside of regular operating days and when work or personal schedules do not allow participation in the Vanpool. 7. Termination of either an individual or the group from the Vanpool Program may occur for the failure to pay rider fares, disruption of Vanpool operation, failure to meet minimum number of participants, or disbandment of the Vanpool Program. 8. Participants will ensure, to the best of their abilities, that no person shall be subjected to discrimination in the conduct of the on the basis of race, religion, color, sex, age, national origin, or disability in any manner contrary to applicable local, state or federal laws and regulations. 9. Participants will indemnify and hold harmless UTA, its authorized agents and employees from all claims, actions, costs, damages, or expenses of any nature whatsoever arising out of or resulting from the use of the Vanpool, including, but not limited to, any delays, tardiness, failure to make an appropriate or scheduled pickup, absence of the van or termination of the Vanpool program. 10. Participants acknowledge that the provides ridesharing referral services without screening the character or background of participants or applicants. Participants agree that UTA shall have no responsibility or liability for any acts or omissions of Vanpool Participants. 11. Participants acknowledge and agree the fare to ride a UTA Vanpool is based on the number of miles the Vanpool group travels and generally is proportionate to the number of participants in a Vanpool group, e.g. ten (10) participants each pays 1/10th. Individual Vanpool groups may vary. Fares will be evaluated on a quarterly basis and may be adjusted if needed. See current UTA Vanpool Pricing sheet at www. utarideshare.com. Section B: Bookkeepers Bookkeepers in the agree to comply with the following terms and conditions, in addition to those terms and conditions set forth in Sections A and D, if applicable: 1. Bookkeepers shall ensure that all individual payments have been submitted by the fifth (5th) of the month either online or by collecting and submitting individuals' checks to UTA. 2. Bookkeepers agree to verify roster, and individuals' roles (driver, rider, point of contact) on a monthly basis. 3. Bookkeepers may pay and be reimbursed for miscellaneous operating expenses as detailed in the Vanpool Program Manual. Any expense more than 50 requires preapproval from UTA. 4. Bookkeepers shall submit daily ridership and ending odometer readings on a monthly basis by the fifth (5th) day following the end of month. 5. Bookkeepers shall confirm that appropriate van maintenance has been completed on a monthly basis. Section C: Driver Selection Criteria Drivers in the, including Primary and Backup Drivers must meet the following Driver Selection Criteria prior to being approved to drive a UTA Van: 1. Be at least 21 years of age; 2. Have a current and unrestricted driver s license and have driven in the United s for at least five (5) years; 3. Have no more than two (2) moving violations in the past three (3) years; 4. Have no more than one (1) not at fault accident within three (3) years. Individuals who have any of the following are ineligible to drive a UTA Van: 1. The suspension or revocation of a driver's license within the past five (5) years; 2. A conviction within the past ten (10) years for reckless driving, hit and run, leaving the scene of an accident, DUI, DWI, felony, or concurrent violations of lane changing; 3. Medical condition or use of prescription medication that impairs a driver s ability to drive a van safely; 4. A person who has filed a Certificate of Financial Responsibility (SR-22) due to his or her personal driving record. 1

2 Section D: Drivers Each Driver, including Primary and Backup Drivers, who drives in the, agrees to comply with the following terms and conditions, in addition to those terms and conditions set forth in Section A: 1. Drivers shall maintain a valid driver's license as required by the of Utah. For Utah issued licenses, as a courtesy, UTA will request a copy of your Motor Vehicle Record. For an out of state license, please request a copy of your Motor Vehicle Record and submit with your Participation Agreement. 2. Drivers shall notify UTA Vanpool in two (2) business days if they no longer meet the Driver Selection Criteria and must immediately stop driving UTA vans. 3. Drivers must complete the UTA Vanpool Driver Orientation prior to taking possession of or operating vans. 4. Drivers shall exemplify safe driving habits and observe all traffic laws and regulations. Drivers are responsible for resolving any citations resulting from the operation and parking of a UTA van. 5. To ensure continued Vanpool operation, Backup Drivers shall assume all responsibilities of the Primary Driver when acting in that capacity. 6. Drivers shall drive vans daily to and from work/school, picking up and discharging riders in accordance with mutually established routes and schedules. 7. Drivers shall coordinate maintenance, cleaning and servicing of vans as specified in the Vanpool Program Manual. 8. Drivers shall keep daily and monthly ridership log of vehicle, participants and odometer records. 9. In case of van breakdown, Drivers shall coordinate with UTA Vanpool Maintenance Supervisor the use of loaner vans. 10. Drivers shall coordinate with participants of the Vanpool group to establish the rules for the day-to-day operation of Vanpool (e.g., wait times, radio). 11. Drivers shall comply with the policies and rules in the Vanpool Program Manual related to personal use of vans. The transportation of non-vanpool Participant groups, such as church, sports, or scout groups, is not allowed. 12. Drivers agree they shall be considered volunteers under federal and state laws and shall not hold themselves out to be nor act as employees or agents of UTA. 13. Drivers shall at all times operate vans in a manner complementary to the public nature of the Vanpool Program, drive in a courteous manner, and if asked, explain the unique character of the use of the van. 14. Except in emergency situations, operation of vans shall be restricted to UTA-approved Drivers. 15. Drivers shall report any accident or damage to the UTA van to the UTA Vanpool Maintenance Supervisor within 24 hrs. 16. Drivers shall not use vans for any other purpose other than for transportation to and from work or school. Drivers shall not use vans for business purposes or for hire; to pull trailers, boats, etc; to haul garbage, debris, or excessive loads; for any purpose requiring the removal of seats; or for any other purposes described in the Vanpool Program Manual. Drivers acknowledge that they shall have full liability and responsibility for all damage to vans occurring if the vans are used for other than permitted purposes or in a manner inconsistent to these Terms and Conditions and the Vanpool Manual. 17. Drivers shall drive vans only on hard surfaced streets, highways, other maintained roads and driveways. Drivers shall not drive vans off-road, on beaches, in fields, or in any other potentially unsafe environment. 18. Drivers shall not drive vans over bridges or roads posted for less than a 4-ton maximum weight load. Drivers shall observe width and height clearance requirements of and for the van at all times (i.e. carwash, drive thru). 19. Drivers shall not allow accessories, including window or bumper stickers, appearance items or additional equipment, to be added to or removed from the Van without prior approval of UTA Vanpool. Section E: UTA Vanpool UTA Vanpool agrees to comply with the following terms and conditions: 1. Provide funding for fuel, servicing and maintenance of Vans. 2. Help Drivers and Bookkeepers fulfill their administrative obligations, including providing instructions for ridership reporting, adding and removing participants. 3. Provide loaner vans by reservation on a first come, first served basis. 4. UTA Vanpool reserves the right to terminate a Vanpool group. 5. Establish and maintain a fare schedule for participation in Vanpools. 6. Ensure, to the best of its ability, that no person is subjected to discrimination in the conduct of the Vanpool Program on the basis of race, religion, color, sex, age, national origin, or disability in any manner contrary to applicable local, state and federal laws and regulations. 7. Provide Vanpools with the Vanpool Program Manual (located in the van or online) outlining policies and rules applicable to the Vanpool Program. 8. Allow approved Drivers to use vans for personal use in accordance with the policies and rules set forth in the Vanpool Program Manual. 9. Provide liability coverage at statutory limits of a van including bodily injury, property damage, comprehensive, collision, and uninsured motorist protection; provided, the van was being operated by a UTA-approved Driver and for a purpose permitted under these Terms and Conditions and the Vanpool Program Manual. 10. UTA may suspend the use of the Fuel Card for a pattern of misuse of the van, failure to pay on time or for insufficient payment. 2

3 Reset Form Vanpool Request Save As As a UTA Vanpool Participant, I am requesting to participate as (check all that apply ): Part-time Rider Van Number: Full-time Rider Vanpool Join : Bookkeeper Backup Driver Group Point Of Contact: Primary Driver Participant Application Participant means all persons, including drivers, backup drivers, riders, and bookkeepers who are transported to and from work/school in a Vanpool operated as part of the or are otherwise authorized by UTA to participate in the program. Name: First Home Address: Middle Mailing Address: Phone Numbers: Home Address: Employer Information: Address: Info: Last Nickname Apt # Apt # Cell Work Fax Work Home Please check preferred address. information will be communicated by . Employer Name Job Title Suite/Gate Length of Employment Emergency Contact: Supervisor's Name Full Name Supervisor's Phone # Relationship Phone # As a condition of participating in the UTA Vanpool program administered by UTA, I agree to comply with the UTA Vanpool Terms and Conditions, a copy of which I have received. I understand and acknowledge that this Agreement, together with the Vanpool Program Manual, establish my rights and responsibilities as a participant in the. As a Vanpool participant, I understand that UTA will store my personal information in an electronic database.* I certify that the above information is true and correct and agree to submit a new application should any of the information provided above change. I understand this Agreement shall be effective on the date signed and shall continue in force until either party gives fifteen (15) days written notice of an intent to terminate. I understand that I must give written notice of termination to the group point of contact and UTA Vanpool. *The Vanpool Privacy Policy is available online at Please or fax Participation Agreement. to: Your Vanpool Support Specialist OR Phone: Fax to: (801) (801) Administrative Use Only VCode: MVR Requested: Commuter ID #: Rider Auth. Sent: Company Code: Driver Auth. Sent: Entered: Removed: 3

4 Driver Applicants Only Please review Section C: Driver Selection Criteria. Information from the Driver Application and your Motor Vehicle Record will confirm whether or not you meet the Driver Selection Criteria. UTA reserves the rights to deny applicants who do not meet the Driver Selection Criteria. Driver Info: Full Name as it Appears on Your License of Birth License Number Issuing Valid and Unrestricted Issued * For Utah Issued License only: As a courtesy, UTA will request a copy of your Motor Vehicle Record. * For an Out of License: please request a copy of your Motor Vehicle Record and submit with your Participation Agreement. 1. Do you have a large vehicle certification (15 passenger capacity or larger)? a. Certification from: : 2. Have you ever had an automobile license or privileges suspended, revoked or refused in the last 10 years? 3. Have you ever been convicted of driving while intoxicated or under the influence of drugs? 4. Do you have personal automobile insurance? a. Name of Insurance Company: Yes No 5. Have you ever had an insurance company refuse, cancel, refuse to renew, or given notice of intention to cancel? 6. Have you been required by any state to file evidence of Financial Responsibility (SR-22)? Yes No 7. Indicate any driving convictions or citations (other than parking) you have been convicted of, forfeited bail or paid any fines for during the past 3 years. a. b. c. How many? Please give full details below. Additional remarks may be continued on a separate sheet. 8. How many motor vehicle accidents of any kind or cause have you as an operator been involved in during the past 3 years? Please give full details below. Additional remarks may be continued on a separate sheet. a. Bodily Injury b. Bodily Injury Who was at fault Who was at fault Violation - Type Violation - Type Description: Description: Damage to your Vehicle Damage to your Vehicle Damage to Other Property Damage to Other Property 4

5 Safety is a top priority for UTA. Please consider your personal health when applying to be a Vanpool Driver. I certify that I do not have any medical conditions or take any medications that interfere with my ability to safely operate a UTA Van. In the event I develop a medical condition or begin taking medication that interferes with my ability to safely operate a UTA Van, I agree to immediately stop driving a Van until I can safely operate it. Examples of health conditions that may interfere with the ability to safely operate a UTA Van include, but are not limited to: vision problems, deafness, paralysis, convulsions, seizure disorders, epilepsy, loss of consciousness, diabetes, heart disease, etc. Examples of disqualifying medication include, but are not limited to, medications that contain prohibitions on driving. I understand that any electronic handheld device usage while driving a UTA van is strictly prohibited. I certify that the information I provided in the Driver Applicant portion of this Application is true and correct and agree to submit a new application should any of the information provided above change. I authorize UTA to verify any information provided herein. I agree that I will not hold myself out to be a Primary or Backup Driver in the until I have received written approval by UTA Vanpool. As a condition of participating in the, I agree to comply with the UTA Vanpool Terms and Conditions and the rules set forth in the Vanpool Program Manual, copies of which I have received. Bookkeeper Only Only one (1) Bookkeeper per Vanpool group. Please verify with your Vanpool Group Point of Contact who is the Bookkeeper. I have carefully read, understand and agree to the Terms and Conditions Section B: Bookkeepers. I agree to provide accurate and timely information as required by the Terms and Conditions. Please or fax all Participation Agreements and Driver Applications. to: Your Vanpool Support Specialist OR Phone: (801) Fax to: (801) Mail to: UTA Vanpool Operations PO Box Salt Lake, Utah Physical Address: No Mail Service 4384 S 50 W, Murray, Utah rev CB

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