Mobile PM/DOT Service Form
For providing In A Pinch Diesel Services with more information regarding your fleet in order to get scheduled for timely PM services and DOT Inspections.
Contact Information
Person to make decisions on repair(s):
Company Name
*
Point Of Contact
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Service Details:
Fleet information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list all equipment you wish to include in our fleet management records. This allows us to have a complete list of your fleet vehicles that you wish to have us service for you. We will not share any sensitive information regarding your fleet or business with any entity unless required to do so by law.
I.E. *2018 Freightliner M2 unit #345. 2017 Western Star 4700 Unit #678.
How often would you like Preventative Maintenance (select all that apply). It is generally recommended that semi-tractors change oil every 10,000-15,000 miles or every 500 hours, whichever comes first. This selection does not sign you up for recurring charges or services, this is purely so that In A Pinch Diesel Services can write up our invoice correctly.
Every 5,000 miles
Every 10,000 miles
Every 15,000 miles
Every 20,000 miles
Every 250 hours
Every 500 hours
Every 750 hours
Every 1,000 hours
Other
If "Other" please explain:
Unit requesting service
*
I.E. Unit #345 needs PM
FULL VIN of unit requesting service
*
Date and time of service needed.
*
Sign below confirming that you understand our mobile service rate is $125/hour and $3/mile. We will only charge for mileage to and from your yard, and no call out fee for scheduled services.
*
Sign below confirming that you understand that our mobile technician may leave the location in order to source parts or tools and time spent will be billed unless otherwise stated.
*
Payment Method
*
Please Select
Card
Cash
Payment App (paypal, cashapp, etc.)
Continue
Continue
Should be Empty: