Customer & Vehicle Information

Car Make & Model *

Year *

Color *

Lic. Plate *

VIN# *

Date and Time *

First Name *

Last Name *

Street Address and Postal Code *

City *

Phone Number *

Email Address *

Reason for tow: *

Pickup Address: *

Drop-Off Address: *

FEES

Standard Collision Tow ($425)

Collision Tow Incl. Winch/Recovery ($600)

Non Collision Tow (As Quoted)

Winch/Recovery ($175)

Upright Overturned Vehicle ($175)

Vehicle Storage ($95/Day)

Re-Tow From CRC ($300)

Second Vehicle To Assist ($180)

Wait Time At CRC $65/hour

Mileage over 20kms $3.75/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 *

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DATE * +

Customer Name *

Customer Signature *

clear

DATE * +