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Admin
2022-07-01T21:40:17-04:00
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*
" indicates required fields
Company Name
*
Address, City , Zip Code
*
Business Phone Number
*
Email Address
*
Radius of Operation
*
List name of ALL drivers and date of birth and driver's license number
*
List Year, Make, Model and VIN# of ALL vehicles and Value of each Vehicle
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Any claims in the past 3 years?
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Yes
No
Do you transport passengers on stretchers?
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Yes
No
Do you transport disabled people?
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Yes
No
Do you have surveillance camera installed in each vehicle?
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Yes
No
Is ALL transportation provided on Pre-Scheduled Arrangement Pick-Up?
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Yes
No
Do you check new drivers for: driving records, criminal background, offensive sexual background?
*
Yes
No
Do you mandate employees to take Passenger Service and Safety (P.A.A.S) Training Program?
*
Yes
No
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