Test Form

"*" indicates required fields

Step 1 of 2

Car Make & Model*

Year*

Color*

Lic. Plate

VIN#

First Name

Last Name

Street Address and Postal Code

City

Phone

Reason for tow:*

Pickup Address:*

Drop-Off Address:

FEES

Option*

Standard Collision Tow ($300)

Flatbed Collision Tow ($350)

Non Collision Tow ($175)

Winch/Recovery ($125)

Upright Overturned Vehicle ($125)

Vehicle Storage ($60/Day)

Re-Tow From CRC ($150)

Second Vehicle To Assist ($125)

Wait Time At CRC $60/hour

Mileage over 20kms $3.35/km

NOTES FOR FEES:

NOTE: I understand that the $72.50 security tow to safety will be included in the charges to my insurance company.

Key #

Truck Operator Name *

Truck Operator Signature*

Date*

Customer Name

Customer Signature*

Date

Total