Information
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Location
Vehicle Used:
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2013 GMC Savannah 15 Passenger VIN 1GJZ71FG2D1112448
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2015 DODGE Caravan 4PCV Passenger VIN 2C7WDGBG2FR703215
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2007 CHEVY Silverado VIN 3GCEC13037G504362
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2016 FORD Transit VIN 1FBZX2ZM2GKB25681
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2019 DODGE Caravan VIN 2C7WDGBG5KR607282
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2019 FORD Transit VIN 1FBZX2CG0KKA52599
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2019 FORD Transit VIN KJ061NRB2X950004540
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OTHER
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Please indicate
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Starting Mileage
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Ending Mileage
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Conducted on
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Prepared by
UNDER HOOD
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Oil
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Windshield Washer Fluid
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Battery
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Hoses/Belts
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Coolent Leaks
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Radiator Fluid
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COMMENTS
SAFETY EQUIPMENT
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First Aid Kit
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Bloodborne Kit
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Flares/Triangles
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Back Up Alarm
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Seat Belt Cutter
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Rear Door Buzzer
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Accident Kits
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Fire Extinguisher
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COMMENTS
WHEELCHAIR LIFT & SECUREMENT
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Lift Mechanism
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Lift Belts
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Safety Plate
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Manual Pump Arm
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Shoulder Lap Belts
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Floor Securement
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Belts
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COMMENTS
EXTERIOR
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Mirrors
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Tires
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Head Lights
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Marker Lights
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Tail/Brake Lights
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Turn Signals
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Windshield Wipers
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Body Damage
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Take a Picture of the Damage
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Cleanliness
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Doors
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COMMENTS
INTERIOR
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Steering
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Transmission
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Horn
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Mirrors
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Gauges
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Heater/AC
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Radio
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Cleanliness
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Vehicle Brakes & Parking Brakes
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Step Well & Dome Lights
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Emergency Exit
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COMMENTS
PASSENGER INFORMATION
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Passenger Names:
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COMMENTS