§ 36-8-24-5 — Required forms

(a) A test administrator shall generate a written
form for each vehicular carbon monoxide test conducted on behalf of
the test administrator's fire department.
(b) Each form described in subsection (a) must contain entries for
the following identifiers:
(1) Name of the motor vehicle owner.
(2) Address of the motor vehicle owner.
(3) Telephone number of the motor vehicle owner.
(4) Vehicle year.
(5) Vehicle make.
(6) Vehicle model.
(7) License plate number.
(8) State in which the motor vehicle is registered.
(9) Name of the fire department responsible for the administration
of the vehicular carbon monoxide test.
(10) Serial number of the direct read instrument.
(11) Unit model number of the direct read instrument.
(12) Carbon monoxide reading for the motor vehicle after five (5)
minutes.
(13) Carbon monoxide reading for the motor vehicle after ten (10)
minutes.
(14) Date of the vehicular carbon monoxide test.
(15) Time of the vehicular carbon monoxide test.
(16) Name of the motor vehicle owner (printed).
(17) Name of the motor vehicle owner (signature).
(18) Name of the test administrator (printed).
(19) Name of the test administrator (signature).
(20) Any other information required by the standard record
keeping practices of the fire department responsible for the
administration of the vehicular carbon monoxide test.
(c) In addition to the information required under subsection (b),
each form shall contain the following language:
"The motor vehicle owner receiving carbon monoxide test results
for a motor vehicle recognizes and agrees that the carbon monoxide test
results provided are the result of a vehicular carbon monoxide test
conducted by the device listed on the date and time indicated and under
the conditions present at that date and time. The readings obtained by
the vehicular carbon monoxide test do not constitute a warranty that the
tested motor vehicle has a carbon monoxide issue or that the vehicle is
free from any carbon monoxide issue.
In consideration for receiving the vehicular carbon monoxide test
from (insert the name of the fire department) at no charge to the
recipient, the recipient agrees to discharge and hold harmless (insert
the name of the fire department), and its agents, employees, and
officers from any and all actions, claims, causes of action, demands,
damages, including punitive damages, and expenses arising from or
relating to the results of the vehicular carbon monoxide test. This
release specifically applies to any claims made or implied based upon
the readings derived from the vehicular carbon monoxide test. This
release from liability is binding regardless of whether a claim or
expense is caused, or alleged to have been caused, by the sole, joint,
several, or comparative negligence of the (insert the name of the fire
department) or by any other alleged breach of duty or warranty, express
or implied, by the (insert the name of the fire department).
The recipient of the vehicular carbon monoxide test represents that
he/she will, upon disclosure of the test readings and test administrator
recommendations, assume all responsibility for all automotive
diagnostics and repair. It is the responsibility of the recipient of the
vehicular carbon monoxide test to schedule any recommended
diagnostic services or repairs.
This agreement constitutes a waiver that covers the entire period
from the date the results of the vehicular carbon monoxide test are
presented to the owner of the motor vehicle through and after the date
the owner submits the motor vehicle to an automotive specialist for any
desired or recommended repair, maintenance, or service.".
(d) All completed and original forms shall be permanently stored:
(1) by the fire department responsible for the administration of the
vehicular carbon monoxide test; and
(2) in a manner consistent with the current record keeping
practices of the fire department responsible for the administration
of the vehicular carbon monoxide test.

Legislative History

As added by P.L.8-2018, SEC.2.