Vehicle Safety & Image Checklist
| Location |
1413 1039 Main Street Shelbyville, KY 40065 |
| Driver's Name: |
Bradley Gold
|
| Driver's License/State: |
G13438428/ky
|
| Vehicle Tag: |
Bfb160
|
| State: |
Ky
|
| Year/Make: |
13/smrt
|
| Owner's Name: |
Bradley Gold
|
| If not Driver, permission to drive on file: | |
| Insurance Company: |
Kyfb
|
| Policy #: |
0020938276
|
| Expires: |
7.25.2021
|
| Photo of Insurance | |
|
|
| SAFETY | |
| Brake Lights | Yes |
| Notes | |
| Tail Lights | Yes |
| Notes | |
| Rear Turn Signals | Yes |
| Notes | |
| Reverse Lights | Yes |
| Notes | |
| Headlights | Yes |
| Notes | |
| High Beams | Yes |
| Notes | |
| Front Turn Signals | Yes |
| Notes | |
| Horn | Yes |
| Notes | |
| Windshield Wipers | Yes |
| Notes | |
| Tire Pressure & Tread | Yes |
| Notes | |
| Mirrors | Yes |
| Notes | |
| Driver's Seat Belt | Yes |
| Notes | |
| Brake Pedal Pressure | Yes |
| Notes | |
| IMAGE | |
| Body is in good repair | Yes |
| Notes | |
| Nothing offensive | Yes |
| Notes | |
| Exterior is clean | Yes |
| Notes | |
| Interior is clean | Yes |
| Notes | |
| Car Top Sign fits on roof | Yes |
| Notes | |
| Inspected By: |
Whitney Sacra
|
Signature:
|
|
| Date: | March 5, 2021 |
| Inspector's Title: | GEN MGR |
Driver's Signature:
|
|
| Date: | March 5, 2021 |
| Supervisor Email: | [email protected] |
