Heavy Duty Rescuer Registration (Mobile Technician)

Heavy Duty Rescuer Registration (Mobile Technician)

Register as a mobile technician for the road rescue network. Complete all required steps to get started.
welcome! let's get you set up as a road rescue network mobile technician. what's your first name?*
and your last name?*
do you operate under a company name?
what's your email address?*
example@example.com
what's your phone number?*
Please enter a valid phone number.Format: (000) 000-0000.
Yes I agreeNo
iPhoneAndroidOther
what's your date of birth?*

MonthDayYear
Date
what's your home/business address?*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
do you have a DOT number?
do you have an MC number?
Diesel Engine RepairGas Engine RepairTransmission RepairA/C Service HVACAPU RepairExhaust DPF After-TreatmentElectrical SystemsBrake RepairSuspension SteeringFuel System RepairMobile DiagnosticsForced RegensDOT InspectionsPM Preventative Maintenance
Brake Repair Air ElectricLanding Gear RepairLiftgate RepairMobile WeldingTanker RepairLighting ElectricalFifth Wheel KingpinRoll-Up Door Repair
Tire Repair Plug PatchTire ReplacementTire Mounting DismountingWheel Seal RepairHub Bearing ServiceRoadside Tire Service
Refrigeration Reefer RepairLocksmith Lockout ServiceHeavy Equipment RepairCrane InspectionsForklift ServiceBus RepairRV Repair
what's your hourly rate? (port-to-port, includes travel)*
what's your minimum charge to roll?
after hours rate per hour?
weekend rate per hour?
emergency/holiday rate per hour?
Up to 25 milesUp to 50 milesUp to 75 milesUp to 100 miles100+ miles
what areas do you want to cover? (city, zip, or region)
Service truck with craneService vanService truck no craneMobile trailer workshopMultiple vehicles
Diagnostic computer softwareWelding equipmentTire changing equipmentAir compressorGeneratorCrane lifting equipmentParts inventory on truck
ASE CertifiedCummins CertifiedDetroit CertifiedFreightliner CertifiedVolvo Mack CertifiedInternational Navistar CertifiedHVAC Reefer CertifiedOther
Less than 1 year1-3 years3-5 years5-10 years10+ years
what's your driver's license number?*
which state issued your license?*
when does your license expire?*

MonthDayYear
Date
what's your general liability policy number?*
general liability coverage amount?
general liability expiration date?*

MonthDayYear
Date
what's your auto liability policy number?*
auto liability expiration date?*

MonthDayYear
Date
YesNoNot applicable
Yes I have coverageExempt - sole proprietor with no employees
workers comp policy number?
workers comp expiration date?

MonthDayYear
Date
NoYes
NoYes
if yes to either, please explain
what's your bank name?*
Credit Debit CardFleet Cards ComChek T-Chek EFSCashDirect InvoiceRoadSync
upload your driver's license*

Cancelof
upload your certificate of insurance (COI)*

Cancelof
upload your W-9 form*

Cancelof
upload a photo of your service vehicle*

Cancelof
upload photo of your equipment setup (optional)

Cancelof
reference 1 - company name
reference 1 - contact name
reference 1 - phone
Please enter a valid phone number.Format: (000) 000-0000.
reference 2 - company name
reference 2 - contact name
reference 2 - phone
Please enter a valid phone number.Format: (000) 000-0000.
reference 3 - company name
reference 3 - contact name
reference 3 - phone
Please enter a valid phone number.Format: (000) 000-0000.
Please sign below to complete your registration.*
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