B&M Associates Vehicle Check 2015

• Document No.

• Conducted on

  Date

• Conducted by

  Select Bev Digby Lee Fry Tim Bell Sergio Goicoechea Wendy Hanney Paul Moody Nicola Parker Shaun Sawyer Dawn Cross Hollie Freeman Sam Garland Ryan Greaves Chris Healey Becki Shelton

  • Bev Digby
  • Lee Fry
  • Tim Bell
  • Sergio Goicoechea
  • Wendy Hanney
  • Paul Moody
  • Nicola Parker
  • Shaun Sawyer
  • Dawn Cross
  • Hollie Freeman
  • Sam Garland
  • Ryan Greaves
  • Chris Healey
  • Becki Shelton

• Car

  Kia C'eed (FG13 LLN)

  Other

• Starting Odometer

• Fuel Level

  1

  3/4

  1/2

  1/4

  0

• Finish Odometer

• Fuel Cost

Fluids

• Fluid levels

  OK

  Fault - Rectified

  Fault - Exists

• Any visible leaks?

  Yes

  No

Lights

• Headlights?

  OK

  Fault - Rectified

  Fault - Exists

• Brake Lights?

  OK

  Fault - Rectified

  Fault - Exists

• Indicators?

  OK

  Fault - Rectified

  Fault - Exists

• Additional Lights (e.g. fog, reversing)

  OK

  Fault - Rectified

  Fault - Exists

Tyres

• Tyre Pressure?

  OK

  Fault - Rectified

  Fault - Exists

• Tread Depth?

  OK

  Fault - Rectified

  Fault - Exists

• Overall Condition?

  Good

  Poor

• Spare Tyre?

  OK

  Fault - Rectified

  Fault - Exists

• Is there any exterior damage?

  Yes

  No

• Please take a photo of the damage and annotate as necessary

  Media

Controls

• Horn?

  OK

  Fault - Rectified

  Fault - Exists

• Door Locks?

  OK

  Fault - Rectified

  Fault - Exists

Miscellaneous

• Seat Belts?

  OK

  Fault - Rectified

  Fault - Exists

• Emergency Kit (high viz vest/jackets, screen wash etc)

  OK

  Fault - Rectified

  Fault - Exists

Comments

• Please enter any additional comments here

• I declare that the vehicle is in a roadworthy condition to the best of my knowledge

  Sign

• Vehicle check complete!
  
  Please complete finishing odometer and fuel cost on return
  Email as PDF to Paul Moody