Company Name:
Address:
City / State / Zip:
,
Phone # :
(i.e. 319-266-1234)
Date of Tow:
MTS #:
Member's Name:
Motorcycle Make/Year:
License/ State:
Vin #:
CONTRACTED RATES
Dispatch Fee:
$
Includes:
(Miles/KM)
Milage/KM Rate:
$
(Per loaded Mile/KM)
CHARGES ($)
Dispatch Fee:
Milage Charged for:
(Miles/KM) :
** Storage:
(Days) AT
(per day)
Additional Charges
(Please explain):
TOTAL:
** MTS pays a maximum storage rate of $10.00 per day for a maximum of 3 days.
MTS PAYMENT TERMS - (No invoices will be paid after 90 days from date of tow)
Date:
/
/
Full Name:
Title:
105 N. State Street - P.O. Box 559 - Denver, IA 50622 | TOLL FREE: 800-999-7064 | PHONE: 319-984-6124 | FAX: 319-984-6132
This site created and powered by
VGM Forbin.
Copyright 2008 : MOTORCYCLE TOWING SERVICES, L.C. All Rights Reserved.
