Information
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Vehicle number
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Conducted on
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Prepared by
VEHICLE DESCRIPTION
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Driver / Vehicle Number
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Odometer reading
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Take a picture of the vehicle
EXTERIOR LIGHTING (Take photo's of any damage)
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The high and low beams are operational.
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The left and right tail lights are operational.
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The left and right front turn signals are operational.
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The left and right rear turn signals are operational.
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The left and right break lights are operational.
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The left and right back-up lights are operational.
EXTERIOR BODY AND GLASS (Take photo's of any noted damage)
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The windshield is free of cracks and chips
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The front hood, grill and bumper are free of damage.
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The mirrors are adjustable and free of damage.
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The body is free of damage.
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The vehicle is clean and free of road grime and dirt.
TIRES
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The front driver tire is in a good condition with no visible signs of damage.
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The rear driver tire is in a good condition with no visible signs of damage.
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The rear passenger tire is in a good condition with no visible signs of damage.
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The front passenger tire is in a good condition with no visible signs of damage.
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The spare tire is in a good condition with no visible signs of damage.
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All the wheels/mags are free of damage.
INTERIOR
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Fire extinguisher
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First aid kit available
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The seat belts are in good condition and operational .
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The windshield wipers are functioning and in a good condition.
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The windshield washer fluid level is acceptable and the washer is operational.
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The heater and defroster are operational.
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The airconditioning is operational.
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The dashboard lights are operational.
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All the gauges are operational and show within the acceptable ranges.
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The interior compartment lights are operational.
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The interior is clean and free of loose objects.
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The seats are in good and clean condition.
REQUIRED DOCUMENTATION
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The vehicle is serviced according to the manufacturers schedule.
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Tag, inspection, and insurance card up to date.
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Note the date of the last service.
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Note the odometer reading at the last service.
SIGNATURES
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Signature of driver / responsible person