Vehicle Request Form
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2VEHICLE REQUEST FORM
Agency: _________________________________________________
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Describe the vehicle requested (vehicle class or suggested make/model
):
________________________________________________________________________
Describe how the agency will use the vehicle:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Indicate the approximate number of miles the vehicle will travel each month: _________
Indicate the approximate number of days the vehicle will be used each month: ________
Will the vehicle need special equipment? Yes _____ No _____
If yes, describe the specific equipment needed:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Will the vehicle be used to transport clients/inmates? Yes _____ No _____
If yes, indicate the approximate number of clients/inmates per trip: _____________
Will this vehicle be used for purposes other than transportation of persons (i.e.: grounds
maintenance, transportation of equipment, etc.)? Yes _____ No _____
If yes, describe the purpose. If this vehicle is to be used for the transportation of
equipment, list the specific equipment to be transported, specifying its weight and
surface area:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Will this vehicle be used to tow? Yes _____ No _____
If so, please list what will be towed, the frequency and the weight of the cargo:
___________________________________________________________________
___________________________________________________________________
Is a four-wheel drive vehicle needed? Yes _____ No _____
If yes, please describe the specific conditions that dictate this requirement:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
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DAS retains final authority to make decision regarding make and model of vehicle.
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Parent category: Business