Vehicle Inspection Checklist
| Store # |
6206 2930 W Jewell Ave Denver, CO 80219 |
| Driver First Name |
Dakota
|
| Driver Last Name |
Falon
|
| Is this a new hire? | No |
| [email protected] | |
| Please take a back end photo of the vehicle | |
|
|
| Photo of Registration | |
|
|
| Registration Expires | September 30, 2021 |
| Photo of drivers license | |
|
|
| Drivers License# |
161791066
|
| State |
Co
|
| Expires | December 11, 2021 |
| INSURANCE | |
| Insurance Company |
American Family Insurance
|
| Policy Number |
410179917990
|
| Expires | June 4, 2021 |
| Photo of insurance card | |
|
|
| Items | |
| Seat Belts | Pass |
| Brakes | Pass |
| Horn | Pass |
| Windshield and wipers | Pass |
| Tires (Safe Thread Depth) | Yes |
| Photo | |
|
|
| Both headlights | Pass |
| Reverse lights | Pass |
| Brake lights | Pass |
| Both tail lights | Pass |
| Turn signals | Pass |
| Vehicle image: | Pass |
| Photo | |
|
|
| Are there any failures on this inspection? | No |
| Is the driver being pulled from the road? | |
| COMMENTS: | |
Driver's Signature
|
|
| Inspecting Person's Name |
America Morales
|
Inspecting Person's Signature
|
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