Thanks for your interest in our Community Van program!
We recognize that transportation solutions go beyond our fixed route bus service and rideshare. The Community Van program offers passenger vehicles to community organizations and businesses to provide transportation to clients and customers. These vehicles are provided for $1.07 per mile, and are owned and maintained by Pierce Transit, fuel included! Please fill out this form to give us some information about your transportation needs. If you have any questions, please contact Commute Solutions at 253.983.3792 or commutesolutions@piercetransit.org.
Business/Agency Name
*
Type of Organization
*
Please Select
Non-profit
Business or Corporation
Public Entity
Other (explain below)
If "Other", please explain:
Contact Person
*
First Name
Last Name
Title
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Person who will sign the Agreement
*
First Name
Last Name
Title
Primary Purpose and Travel Area for Vehicle
*
Please provide information about transportation services you wish to provide (population served, where you intend to travel, etc.)
Type of passenger
*
Children age 0-12
Children age 13 to 17
Adults age 18 to 60
Adults with disabilities
Elders (age 60+)
Individuals requiring 24-hour supervision
How many passengers will you transport at any given time?
*
Please Select
Up to 6 passengers
7 to 10 passengers
11 to 12 passengers
How long do you anticipate needing the vehicle?
*
Minimum one month
What types of insurance does your organization provide? Please list amount as applicable.
Rows
Limit amount ($)
General liability
Auto liability
Umbrella insurance
Volunteer medical protection
Do you provide State workers' compensation coverage for your employees or volunteers?
*
Please Select
Yes
No
Not applicable (explain below)
If "Not applicable", please explain:
I attest that our organization will be able to supply Pierce Transit with criminal background check verification on proposed drivers AND certificates of insurance.
*
Yes
Not applicable (explain below)
If "Not applicable", please explain:
Does your organization currently operate fleet vehicles?
*
Yes
No
Thank you for this information.
A member of the Commute Solutions team will review your form and contact you shortly.
Submit
Should be Empty: