X hits on this document

PDF document

Cottonwood Heights Police Department Towing Services Rotation Policy - page 12 / 13

112 views

0 shares

2 downloads

0 comments

12 / 13

Business Name

_________________________________________________________________

1) DOB Name __________________________________ Years of Experience_____ Address_________________________________________________ ____________ Phone ________________

Med Card Exp ______________

*NDCP Certified

Yes

  • No

OFFICE USE ONLY!! CERTIFICATION

BCI/UCCH

DL REC

DL MED-CARD

WRECKMASTER/TRIPLEAAA

2)

Name

__________________________________

DOB

____________

Years of Experience_____

Address_________________________________________________

Phone

________________

Med Card Exp ______________

*NDCP Certified

Yes

  • No

OFFICE USE ONLY!! CERTIFICATION

BCI/UCCH

DL REC

DL MED-CARD

WRECKMASTER/TRIPLEAAA

3)

Name

__________________________________

DOB

____________

Years of Experience_____

Address_________________________________________________

Phone

________________

Med Card Exp ______________

*NDCP Certified

Yes

  • No

OFFICE USE ONLY!! CERTIFICATION

BCI/UCCH

DL REC

DL MED-CARD

WRECKMASTER/TRIPLEAAA

4)

Name

__________________________________

DOB

____________

Years of Experience_____

Address_________________________________________________

Phone

________________

Med Card Exp ______________

*NDCP Certified

Yes

  • No

OFFICE USE ONLY!! CERTIFICATION

BCI/UCCH

DL REC

DL MED-CARD

WRECKMASTER/TRIPLEAAA

****This Form must be filled out and faxed to Renita Pullman @ (801) 944-7105 by company owner for every new Tow Truck Operator that is hired after the 2011 Towing Rotation begins**********

TOW TRUCKS (Agreement Article 3) _________________________________________________________________ ________Make____________________Class______LienHolder____________________ Business Name 1) Year

NOTICE OF CONFIDENTIALITY: The contents of all Cottonwood Heights Police Department Policies & Procedures are confidential and for CHPD use only. The contents shall not be viewed by, or distributed by any method to, anyone outside the CHPD unless prior approval is given by the CHPD Chief of Police.

Towing Services

Page 12 of 13

Document info
Document views112
Page views126
Page last viewedMon Jan 23 21:27:52 UTC 2017
Pages13
Paragraphs458
Words5539

Comments