Virtual Pizza Delivery Vehicle Inspection

1

Your Name* This field is required.

First Name

Last Name

2

Your Email* This field is required.

example@example.com

3

Survey Date* This field is required.

Date

4

Location Name or Address* This field is required.

5

Restaurant State* This field is required.

State

Country

7

Brakes / Pedal working in good condition?* This field is required.

YESNO

8

Taillights are all working?* This field is required.

YESNO

9

Horn is working?* This field is required.

YESNO

10

Windshield and Wipers in good condition?* This field is required.

YESNO

11

Turn Signals Working?* This field is required.

YESNO

12

Back up lights working?* This field is required.

YESNO

13

Brake lights all working?* This field is required.

YESNO

14

Safety Belt working and in good condition?* This field is required.

YESNO

15

Tires are safe? (Safe Tread Depth/ No Bald Spots)* This field is required.

YESNO

16

Tires are inflated to recommended pressure?* This field is required.

YESNO

17

Valid insurance card?* This field is required.

YESNO

18

Attach a Picture of the Vehicle's OUTSIDE* This field is required.

Drag and drop files here

Select files to upload

19

Attach a Picture of the Vehicle's INSIDE* This field is required.

Drag and drop files here

Select files to upload

20

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