KMCA Supplies

Fill Out the Supply Form BELOW & Submit it to KMCA electronically

OR download a supply form here and fax or mail it to:

KMCA
PO Box 1673
Topeka, KS 66601
Fax: 785-266-6551 

DO NOT hit the Enter/Return key until you are finished with the form.
Hit tab to go to the next line or click on that space.
Hitting Enter/Return will submit a blank form to KMCA, and you will not receive your supplies.



Most orders shipped within 24 hours

Postage & Handling Costs
C.O.D. - Add $8.50 to charges listed below
Log Books
- Add $10.00 for Case
of 100
Shipping Cost-Other Supplies
$0 - $5 ............................Add $3.95
$5.01 - $10 .....................Add $4.95
$10.01 - $15 ...................Add $5.95
$15.01 - $20 ...................Add $6.95
$20.01 - $30 ...................Add $7.95
$30.01 - $40 ...................Add $8.95
$40.01 - $50 ...................Add $9.95
$50.01 - $75 ...................Add $10.95
$75.01 - $125 .................Add $11.95
$125.01 and up ..............Add $15.00

Add Sales Tax
Handling Charge per Shipment - Add $2.00
20% Surcharge for Non-Members

*denotes required fields

Date
*Name
Company Name
Street Address
City State
Zip
*Mailing Address
*City *State
*Zip
*Phone
Fax
Bill Me C.O.D.
*Email
Payment Terms:
Cash, check or money order due on the 10th of month
Non-Members must pay in advance.

Item Description
Form No.
Cost
Quantity
Driver Handbooks/Log Books
Facts for Drivers
CO890
4.50 ea.
Hours of Service/Driver's Log Manual
85-M
7.50 ea.
Driver Duplicate Log Book MCS59* (1 to 99 log books)
 LOG
1.25 ea.
Log Books (100 or more)
LOGS
1.20 ea.
Looseleaf Log Sheets (1 case=1,000 sheets)
 
85.00/case
Bill of Lading - Agricultural Carriers
(50 sets per pad)
BLFM
4.00 pad
Bill of Lading - (single sheet, triplicate)
BLUMC
.50 ea.
Driver Trip Sheets (50 sheets per pad)
DTS
3.00 pad
Safety and Driver Record Forms
DOT Safety Regulation Management Edition (8.5x11)
17-H
10.50 ea.
DOT Safety Regulations (4x6)
7-ORS-A
3.00 ea.
Driver Qualification File (2 Files)
740-F
7.00 ea.
DQ & Driver ID Wallet Card
7-BC
.50 ea.
Application for Employment (folder stock)
416-F
1.00 ea.
Application for Employment (paper stock)
420-F
.75 ea.
Violations & Review Record (50 per pad)
643-F
4.50 ea.
Certification of Road Test & Pocket Card (duplicate sets & cards)
106-B
.50 ea.
Physical Forms & Certificates (25 forms & 25 certificates)
Med.
25.00 ea.
Physical Set (1 form, 1 card)
PHYSET
1.25 ea.
Inquiry to Past Employers (50 sheets per pad)
409-F
4.50 ea.
Accident Register
33B
9.00 ea.
Accident Investigation Kit
714-R
2.00 ea.
Emergency Response Guidebook (4x6)
104RS
3.40 ea.
Drivers Guide to Hazardous Materials (Revised)
116-ORS
2.90 ea.
Handling Hazardous Materials
370-H
15.00 ea.
Title 49 CFR Hazardous Materials Regulations (100-185)
25-ORS-6
32.00 ea.
Vehicle Maintenance & Inspection
Equipment Maintenance File
VMRS30
1.50 ea.
Power Unit - Inspection & Maintenance Record (50 sheets per pad)
PUMR
2.00 ea.
Semi-Trailer - Inspection & Maintenance Record (50 sheets per pad)
STMR
2.00 ea.
Vehicle Inspection Report Book (31 sets - triplicate)
16-B
2.25 ea.
Vehicle Inspection Report Book - Simplified (31 sets - triplicate)
37-B
2.25 ea.
Annual Inspection Forms (duplicate sets)
200-FS-C2
1.00 ea.
Annual Inspection Decals
49-SN
.50 ea.

Prices are subject to change