Snow & Ice Contract Truck Inspection



Instructions: This form shall be completed as the initial inspection for each truck at the beginning of a new contract. The following items must be attached to this inspection form : FORMCHECKBOX Picture of retrofitted truck (side view) FORMCHECKBOX Copy of proof of ownership FORMCHECKBOX Copy of proof of liability insuranceSECTION 1: VENDOR INFORMATIONNAME FORMTEXT ?????CONTRACT NUMBER FORMTEXT ?????CONTACT PERSON FORMTEXT ?????EMAIL FORMTEXT ?????PHONE FORMTEXT ?????STREET ADDRESS FORMTEXT ?????MAILING ADDRESS (if different) FORMTEXT ?????CITY FORMTEXT ?????STATE FORMTEXT ?????ZIP FORMTEXT ?????SECTION 2: TRUCK INFORMATIONVIN NUMBER FORMTEXT ?????HEIGHT OF TRUCK (highest point to ground)MAKE FORMTEXT ?????MODEL YEAR FORMTEXT ?????Feet: FORMTEXT ?????Inches: FORMTEXT ?????SECTION 3: RETROFIT EQUIPMENT INFORMATIONList the brand and model of the following retrofit equipment:Equipment:Brand:Model:Comments:Snow Plow FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2-Way Radio FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????V-Box Spreader FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Ground Speed Controller FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????CaCl Dispensing System FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 4: RATING INFORMATIONGROSS GVW (minimum 56,000 pounds) FORMTEXT ?????FRONT AXLE GVW (minimum 16,000 pounds) FORMTEXT ?????SECTION 5: INSPECTION INFORMATION Condition:Comments:Twin Drive Tandem FORMCHECKBOX Yes FORMCHECKBOX NoClean Appearance FORMCHECKBOX Yes FORMCHECKBOX NoWindshield Wiper Condition FORMCHECKBOX Excellent FORMCHECKBOX Good FORMCHECKBOX PoorDefrosting System FORMCHECKBOX Excellent FORMCHECKBOX Good FORMCHECKBOX PoorCab Heating System FORMCHECKBOX Excellent FORMCHECKBOX Good FORMCHECKBOX PoorInspector’s opinion as to suitability of unit for snow and ice removal operations: FORMTEXT ?????Judgement as to truck condition (Engine, Drive train, General Appearance): FORMTEXT ????? FORMTEXT ?????INSPECTOR’S SIGNATUREINSPECTION DATE ................
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