CA DMV Form OL 319A. Autonomous Vehicle Deployment Permit Application for Certificate of Self-Insurance

Form OL 319A is utilized by Autonomous Vehicle Testers (AVTs) deploying Autonomous Vehicles (AVs) in California to apply for a Certificate of Self-Insurance. AVTs are required to provide evidence of insurance, and this form allows them to certify self-insurance.

The form consists of sections where the AVT can provide their business information, contact details, and AV deployment information. It may also include sections for insurance policy details, coverage limits, and any additional requirements or disclosures related to self-insurance.

Important fields in this form include the AVT's business name, address, phone number, and email address. Additionally, detailed information about the AVs being deployed under the self-insurance certificate, including vehicle identification numbers (VINs), make, model, and year, may need to be provided. Accurately completing all required information and ensuring compliance with insurance regulations is crucial to obtaining a Certificate of Self-Insurance.

Application Example: An AVT deploying AVs in California would use this form to apply for a Certificate of Self-Insurance. By accurately and completely filling out the form with their business details, contact information, and AV deployment specifics, the AVT demonstrates compliance with insurance requirements. This form is essential for AVTs to establish financial responsibility and legal compliance while deploying autonomous vehicles.

Related Forms: A related form to consider is Form OL 319, which is used by AVTs participating in the AVT Program to apply for a Certificate of Self-Insurance. While Form OL 319A applies to AVTs deploying AVs, Form OL 319 specifically addresses AVTs in the AVT Program. Both forms serve the purpose of certifying self-insurance, but the distinction lies in the stage of involvement in the AVT Program.