New Search
<br /> ' - _ ~ ~ ter.---- _ -r-~-.:: ` <br /> r` <br /> T~ WING SFRV~CF, 'INC., ' ~ I!'s time !o expect more from a (owing company ~ <br /> f: f /i <br /> 1.; , <br /> P. ia. Box 24203 ~ . ~~+r ene, S rin field Fax <br /> .9 p 9 <br /> Fugene, 0R 97402 X54 ~ 342-238fi 54 ~ 126-0222 54 ~ fi83-fi747 <br /> ~ Date Cail # Start Time Firtish Time Billin Code P.4. # 1 Case # <br /> ~ ~AM AM , <br /> Name Hame .Phone # Work. Phone # <br /> r <br /> Address <br /> ~ <br /> t <br /> C...~ State Z!~ ~ adometer~ Driver 1 Regis#ered~Qwneir <br /> Year Make I Model Color <br /> i_ & <br /> ~ <br /> is <br /> r, Vin # State Plate # <br /> . L~ <br /> Location of Vehicle <br /> i ~ a~ mow.. y~ S <br /> Tow to Destination y~ <br /> 1111,,,, <br /> t. <br /> Insurance Policy # ~ Agent's Name <br /> I authorize to a Dannevik's Towin for the service. rovided on <br /> p Y .9 p <br /> Reason for Tow .Mileage Labor Time Extra Person K~ <br /> ? Accident f ~ <br /> ? Abandoned Be . ~ f Finish Finish Y <br /> 9 <br /> ? Tow Zone <br /> ? S~oler~ Finish ~ Start Start. N <br /> Y Arrest ~ Driver # <br /> ? Impounded: Start. Total Total <br /> ~ ? Unknown , . ~ _ ~ <br /> ~ ~ <br /> as <br /> ,x. <br /> ~ ~ ~ ~ <br /> EquipiphServices~ Towing Charges Personals Taken By ~ Date. <br /> ~ ~ . <br /> ~ f;,~ <br /> ' Recovery: Tow . : ~ <br /> ins ~ected b r• Date <br /> Labor Miles ~ <br /> Clean Up Dollies Released To <br /> Lock Qut Drive Line <br /> Method of Payment Cash <br /> I; <br /> E , ,Gas Delivery Jumpstart check # <br /> 2 Gal. Gas Re-Tow <br /> { ~ Cic Guarantee # <br /> Flat Tire ~ R T;.:Miles ~ ~ t <br /> x ~ CC r , , <br /> ~ ` Stand By Storage <br /> f ` Exp, <br /> ~ Dispatch Fee Gate Fee ODL # Ex . <br /> E. p <br /> Flares 2nd Truck Authorized Signature Date <br /> end IT IS UNDERSTOOD THAT IF FOR ANY REASON <br /> ` Outside Charges Truck Miles THIS C~.AIM IS REFUSED BY MY INSURANCE <br /> ~ COMPANY IN PART OR IN FULL, 111VIl.l. ASSURE <br /> Total Total ~ ~ RESPaNSIL.ITY FAR PAYMENT. y <br /> ~ ~ ~ <br /> . s H <br /> ~ <br /> Discount .Grand Total ~ ~ ry'e' <br /> Indicate.Remarks or Dama ed Areas on back of Pink Invoice. <br /> l ~ , <br /> r Vehicle Storage From To : Days @ $ ~ . Requested by . <br /> .We cannot be respprisEbfe.:fordgmages caused •by fauity tires, bumper ijrackets, etc Dannevik's.Towing;assume"s;no responsikiilityfore <br /> ~ ~ loss ar damage by heft, fire or any other `cause,taeyondour corifrol, to.anyvehicle; placed:;with: us-far storage or towing. <br /> ~ - - <br /> <br />