Automobile Vehicle Inspection Form
ADVERTISEMENT
1
2
3Colony Specialty Automobile Vehicle Inspection Form
Named Insured________________________________________ Policy Number: ________________________________
Address ___________________________________________________________________________________________
Vehicle Description (use a separate inspection form for each vehicle inspected):
Year
Make
Model
GVW or Seating
Serial Number
Odometer Reading
Capacity
Select the appropriate Yes or No box for the Power Unit or Trailer to indicate if the following items are in good or
acceptable working order or condition. A comment is required for all No responses.
Power unit:
Yes
No
Yes
No
1. Brakes (front & rear)
9. Speedometer
Yes
No
Yes
No
2. Brake Lights
10. Steering
Yes
No
Yes
No
3. Exhaust Pipe & Muffler
11. Suspension
Yes
No
Yes
No
4. Headlights
12. Tail Lights
Yes
No
Yes
No
5. Horn
13. Turn Signals
Yes
No
Yes
No
6. Mirror
14. Windows
Yes
No
Yes
No
7. Odometer
15. Wipers
Yes
No
8. Seat Belts
Trailer:
Yes
No
Yes
No
1. Brakes
4. Tail Lights
Yes
No
Yes
No
2. Brake Lights
5. Connection w/tractor
Yes
No
6. Turn Signals
Yes
No
3. Suspension
Provide comments for all No responses (indicate Power Unit or Trailer, numeric number of item and provide details).
Use page 3 of the inspection form for any additional comments. If problem has been repaired or corrected, attach
copy of repair receipt or invoice to this inspection form.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Vehicle Inspection (Ed. 6/11)
Page 1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business