Company Car Maintenance Form
Please have this completed by the 1st of every month.
Where does this car live?
*
Please Select
Fargo
Grand Forks
Detroit Lakes
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Car Number
*
Please Select
Car 1
Car 2
Car 4
Car 5
Car 6
Car 7
Car 8
Car 9
Car 11
Car 12
Car D1
Car L1
Car L2
Car L3
Current Mileage
*
Mileage
What Mileage is it due?
*
Mileage
Any chips/cracks in windows?
*
Description
Do wiper blades need to be replaced?
Yes- Front
Yes- Back
Yes- All
No
Do wiper blades need to be replaced?
*
Please Select
Yes- Front
Yes- Back
Yes- All
No
Is check engine light on?
*
Please Select
Yes
No
Is the check engine light on?
Yes
No
Any sign of mice?
*
Description
Is there anything not working in the car?
*
Description (example. AC, outlets, lights, etc)
Is there any damage to the car?
*
Example: dents, scratches, broken bumper, stains, etc.
Is anything missing from the car?
*
Example: gas card, headrest, registration, etc.
Due for a car wash?
*
Please Select
Yes
No
Due for a car wash?
Yes
No
Is there any kind of smell?
*
Description
Does this car need work immediately?
*
Please Select
Immediately
With in 1 week
With in 2 weeks
No work needed
Submit
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