|
People
if you fax this information you will not be put into our data base for
calls.
It must be
mailed.
To Join Our Team We Will
Need The Following.
PAGE
ONE
1.
Full Name: ____________________________________________________
2. Mailing
Address: ______________________________________________
3. City:
__________________________________________________________
4. State:
________________________________________________________
5. Zip Code:
_____________________________________________________
6. Full Company
Name: __________________________________________
7. How Long in
the Business: Years:_________ Months:____________
8. Business
Phone: {_____}_______________________________________
9. Home Phone:
{______}_________________________________________
10. Cell Phone:
{_______}_________________________________________
11. Web
Address: _______________________________________________
12. Pilot Car
Make: ___________________Model: ____________________
13. E-Mail
Address: _____________________________________________
14.
Insurance we must have a copy of your certificate on file showing
1st Pilot Car Companies as a
certificate holder before we will dispatch you on our load.
15. Have your
insurance company fax us a copy of your certificate of insurance showing
1st Pilot Car
Companies.com®
as a certificate
holder
16. Drivers
License Number:________________________________
17.Copies of
all State Certifications and list here:
________________________________________
18.Member of
any Associations please
list:_______________________________________________
19. Drivers in
your company that drive for you list their information on a separate
sheet.
PAGE
TWO
PLEASE
LIST ALL OF YOUR EQUIPMENT HERE
1.
Oversize load sign Width: ________________________________
2.
Oversize load sign Height: ______________________________
3.
Oversize load sign color: _______________________________
4.
Oversize load sign letters: _____________________________
5.
Letter brush stroke size: ______________________________
6.
Letter Height: _________________________________________
7.
Roof Mount: Y/N_______________________________________
8.
Bumper Mount: Y/N____________________________________
9.
List the number, type, color and location of all lights:
10.
S= Strobe H= Halogen A= Amber C= Clear HL= Head Light
TL=
Tail Light ATR= Above the Roof
11.
Number: ______________________________________________
12.
Type: _________________________________________________
13.
Color: ________________________________________________
14.
Location: ____________________________________________
15.
List your communication type and number:
HH=
Hand Held PM= Permanent Mount
16.
Type:_________________________________________________
17.
Number: _____________________________________________
18.
High Pole: Y/N _______________________________________
19.
What is the maximum height it will go: Ft_____ Inch_____
20.
Do you carry extra oversize load signs:
as
required by law: Y/N ________________Number:__________
21.
Do you carry extra flags: Y/N _______Number:__________
PAGE
THREE
Your
Basic Required Equipment Page:
1.
18" Or Larger Cones: Y/N __________Number: ___________
2.
Reflective Triangles: Y/N ___________Number: ___________
3.
18"or 24" Stop/Slow Sign: Y/N ______Size: ______________
4.
Red Burning Fuses: Y/N ____Number: _____Minutes: _____
5.
Flash Light: Y/N ____________Number: ___________________
6.
Orange Vest: Y/N __________ Number: ___________________
7.
Orange Hard Hat: Y/N ______Number: ___________________
8.
18"or 24" Red Flags: Y/N ___Number: 18"______24"______
9.
Hand Held Flag: Y/N ________Number: 18"______24" _____
10.
Fire Extinguishers: Y/N ____Number: ____ Lbs Each: ___
1st
Pilot Car Companies.com® may at any time inspect your
vehicle/equipment for State {s} complaisance.
Warning
Warning Warning
You must
MAIL
this application with copies of all certifications that you have.
Please have
your insurance company fax us your certificate of insurance,
Show our
company 1st Pilot Car Companies as a certificate holder Fax {321}
639-2152.
MAIL
copies of this application, drivers license, W-9 and 3 photos of your
vehicle {different angles}
Business
cards and ALL other paper work that you think might be useful.
We cannot
start your file for you until we receive all the items above.
WITH ALL
COPIES PLEASE MAIL TO:
1st Pilot
Car Companies.com®
6509 Arton
St.
Cocoa, FL
32927
Attn: Carol
Contractor Services |
