Over Dimension Load

Company Contact Details

Please ensure that the person named as escort/pilot is contactable 2 hours prior and during the proposed transport window.

Company name*

Postal Address*

Street Address

Street Address Line 2

CityRegion

Postal / Zip Code

Escort/Pilot name*

First NameLast Name

Escort/Pilot contact phone*

Area CodePhone Number

Email address to receive authorisation number

example@example.com

Alternative contact

Alternative contact phone

Area CodePhone Number

Load Details

Description of load*

Height (m)*

Length (m)*

Width (m)*

Tandem load?

YesNo

If yes, please state total number of loads

Date/Time of Transport

Date*

Date

Time entering Counties Energy network area*

Hour Minutes

AM/PM Option

Transport Route

Start location*

Final destination*

Transport route*

Additional comments

Terms and Conditions

Acceptance and use of an authorisation number is subjet to the conditions listed:

1. The issue of an over dimension load authorisation by Counties Energy Ltd does not exempt the holder from liability for any damage caused by the load, whether it is escorted or not.

2. All due care and attention must be taken whether with an escort or not.

3. When Counties Energy Ltd has advised that the load be escorted, it is to remain at the designated start location until the company providing the escort arrives.

I/We accept the terms and conditions for the transportation of an over size load within the Counties Energy network area.

YesNo

I /We accept all responsibility and agree to pay full cost for any damages on the Counties Energy network caused by works undertaken by myself, my team or the Company as named in this application.If undertaking works for a company, in submitting this application, you confirm that you have the necessary financial authority to accept such conditions, and potential costs incurred.