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i. <br /> I, <br /> i. ~ <br /> ` ~ ~ S <br /> k <br /> ' Taw1NG SERV~C,E, I,NC. ...it's. time to expect more from a towing company <br /> P. Box 24203 Eugene Springfield Fax <br /> Eugene, ~R 97402 X54 342 <br /> 238fi {54 i} 72fi-0222 X54 t) 683-6707 <br /> r <br /> Date Call # Start Time AM Finish Time AM Billing Code P.Q. # 1 Case # <br /> Name Home Phone # Work Phone # <br /> <br /> r Address <br /> i <br /> C~ State Z~ Ddameter Driver 1 Registered Gwner <br /> k. <br /> . ~ Year Make I Model Color <br /> Vin # State Plate # _ <br /> I. <br /> Location of Vehicle <br /> ~ r,: <br /> I. <br /> Tow to Destination <br /> i <br /> I <br /> 1. <br /> 1. ~ <br /> Insurance Policy # Agent's Name <br /> ~ I authorize to pay Dannevik`s Tawing for the service pravided~on <br /> Reason forTow Mileage LaborTime Extra Person K~ <br /> ? Accident ~ <br /> ~ <br /> ? Abandoned Beg. Finish Finish Y <br /> ? Tow Zone <br /> ? Stolen Finish ~ Start Start <br /> r ? Arrest ~ Driver # <br /> i ~ ? Impo~inded Start ~ ~ Total Total <br /> ] Unknown <br /> E. ~ Total + <br /> ~ <br /> I E ui . I Services Towin Char es~>,~,xa Personals Taken By Date <br /> 3. . <br /> r f <br /> Recovery Tow <br /> Labor Miles Inspected by Date. <br /> p. ~ <br /> Clean Up ~ Do lies ~ Released To <br /> Lack Out Drive Line <br /> ~ Method of_Payment Cash <br /> r : Gas Delivery Jumpstart <br /> Check # <br /> C.: <br /> . 2 Gal. Gas Re-Tow <br /> Ck Guarantee # <br /> E:.. <br /> j'.. <br /> Flat Tire R.T. Miles <br /> CC # <br /> Stand By Storage <br /> Exp. <br /> Dispatch Fee Gate Fee . <br /> ODL # Exp. <br /> Y; <br /> Flares 2nd Truck Authorized Signature Date <br /> 2nd 1T IS UNDERSTOOD THAT,IF FOR ANY REASON <br /> Outside Charges Truck. Miles THIS CLAIM IS REFUSED BY MY INSURANCE <br /> COMP NY IN PART 0R IN FULL, I WILL ASSURE <br /> Total Total RE NSIB[LITY FOR AYMENT. <br /> E; Discount Grand Tota ~ _ - <br /> Indicate Remarks or Dama ed Areas on back of Pink invoice. <br /> Vehicle Storage From To Days C~ $ Requested by <br /> We cannot be responsible for damages caused by faulty tires, bumper brackets, etc. Dannevik's Towing assumes no responsibility for <br /> i. <br /> loss or damage by theft, fire or any other cause beyond our control, to any vehicle placed with us far storage or towing. <br /> <br />