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Corporate Name : ________________________ _ <br />Date Incorporated : _____________ State of Charter: _____ _ <br />6. What is the fictitious name under which the business will be conducted (if app licable): ____ _ <br />7. Has this business ever been suspended, revoked or been the subject of suspension, revocation or <br />violation of Local, County, or State Law? <br />8. How many wreckers does the towing agency have in each class? <br />Refer to Equipment Requirements of specifications for class description <br />CLASS A WRECKER <br />CLASS A SLIDE BACK CARE CARRIER ___ _ <br />CLASS B WRECKER <br />CLASS B SLIDE BACK CAR CARRIER <br />CLASS C WRECKER <br />CLASS D WRECKER <br />OTHER: (DESCRIPTION AND NUMBER) ------------- <br />Please provide complete information for each wrecker on the attached equipment form. <br />9. Do you have now or have you had any contracts with private companies? ________ _ <br />If so, list two, including the name and phone number of your contact at these companies: ___ _ <br />10. Has the towing agency filed for insolvency, reorganization or bankruptcy petition (voluntary or involuntary)? <br />11 . List five (5) references preferably public agencies with current or past contracts : AGENCY CONTACT <br />TELEPHONE <br />12. How long has this towing agency been in the towing business? <br />26