Hurricane Survey Form - Water Hauler
DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS Water Hauler Price Survey Name of Business: _____________________________________________________________________ Mailing Address: _______________________________________________________________________ Physical Address:______________________________ Cell:__________________________________ Tel: ____________________________________________ e-mail:_____________________________________ Legal Form of your Business (Corp., Partnership, LLC): _____________________________________ Total Number of Trucks: _____________________________ Truck Capacity: Truck 1: ____________________________ Truck 2: ____________________________ Truck 3: ____________________________ Truck 4: ____________________________ Price Per Truck : Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Are there additional charges depending on Diffic …
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Original source: https://dlca.vi.gov/forms/pdf/Hurricane_Survey_Form-Water_Hauler.pdf
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DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS Water Hauler Price Survey Name of Business: _____________________________________________________________________ Mailing Address: _______________________________________________________________________ Physical Address:______________________________ Cell:__________________________________ Tel: ____________________________________________ e-mail:_____________________________________ Legal Form of your Business (Corp., Partnership, LLC): _____________________________________ Total Number of Trucks: _____________________________ Truck Capacity: Truck 1: ____________________________ Truck 2: ____________________________ Truck 3: ____________________________ Truck 4: ____________________________ Price Per Truck : Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Low: $________________________ to High: $______________________________ Are there additional charges depending on Difficult & Dangerous locations? Yes: _____________________ No: ______________________ Are there additional charges depending on the amount of hoses required for delivery? Yes: _____________________ No: ______________________ Where is your water collected from? (Exp. WAPA) 1.) _____________________________________________ 2.) ______________________________________________ 3.) ______________________________________________ 4.) ______________________________________________ I hereby certify that the information provide herein is true and correct. ______________________________________ _______________________________ ________________ Print your Name Signature Date