Form Center

2. Secured Transportation Service License Application Checklist

   Application for Vehicle Permit - One for Each Vehicle

   1. Application for Vehicle Permit - One for Each Vehicle
   2. Copy of Certificate of Insurance showing Automobile Liability Coverage
   3. Certificate of Mechanical Inspection Form completed by a Licensed Mechanic - One for Each Vehicle
   4. Certification of Compliance signed by the designee of San Miguel County
   5. Application Fee
4. Application for Vehicle Permit
6. Name of Secure Transportation Service:
8. Type of Permit Sought:*
   -- Select One --Type 1 (Partitioned)Type 2 (Non-Partitioned)
10. Vehicle Information:
12. Make:
13. Model:
15. Chassis Year:
16. Vin:
18. License Plate Number:
19. Date in Service:
21. Color:
23. Other Distinguishing Characteristics (e.g. logo):

25. The undersigned acknowledges that the Permit granted pursuant to this application is not transferable, and in the event that the vehicle is sold or transferred, the permit will not transfer.

    The undersigned hereby affirms that the Secure Transportation Service is compliant with all applicable laws and regulations required to operate the above-referenced vehicle in Colorado.  The undersigned represents that he/she has the authority to act on behalf of the Secured Transportation Service, and all information in this application and accompanying documentation is true and accurate to the best of his/her knowledge. 

27. First Name
28. Last Name
30. Title
31. Date
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field