SECTION 1 APPLICANT INFORMATION
Company Name:
Address:
City:
State:
Zip:
Phone:
Authorized Representative’s Name (First, Last, MI):
Position with Organization:
SECTION 2 TAXI CAB INFORMATION
Vehicle #1
VIN#:
Color:
Year/Make/Model:
Capacity:
SECTION 3 TAXI CAB INSPECTION
Front Lights
Comments
Headlights Low Beam
L.F.
R.F.
Headlights High Beam
L.F.
R.F.
Turn Signals
L.F.
R.F.
Parking Lights
L.F.
R.F.
Rear Lights
Reds with/Headlights
L.R.
R.R.
Brake Lights
L.R.
R.R.
Turn Signals
L.R.
R.R.
Backup Lights
L.R.
R.R.
Tires
Tires
L.F.
R.F.
R.R.
L.R.
Brakes
Regular
Emergency
Horn
Window Glass
Condition:
Cleanliness:
Windshield Wipers
Condition:
Operation:
Miscellaneous Items
Rate Card:
Meter Light:
Flares:
Extinguisher:
Additional Comments/Remarks:
City of Hudson
Taxi Cab Inspection
Report
SECTION 1 APPLICANT INFORMATION
Company Name:
Address:
SECTION 2 TAXI CAB INFORMATION
Vehicle #1
VIN#:
Color:
Year/Make/Model:
Capacity:
SECTION 3 TAXI CAB METER/ODOMETER INSPECTION
Odometer Reading
Meter Price
Comments
Mileage at Start:
$
Mile 1:
$
Mile 2:
$
Mile 3:
$
Mile 4:
$
Odometer Additional
Odometer:
Approved
Needs Repair
Meter:
Approved
Needs Repair
Meter Waiting Time Serial #:
1
st
Trip
Seconds
2
nd
Trip
Seconds
Approved:
Needs Repair:
SECTION 4 CAB INSPECTION CERTIFICATION
Automobile Repair Center Business Name:
Address:
City:
State:
Zip:
Phone:
This safety inspection was provided by an automobile repair center and certifies that the vehicle has
been thoroughly inspected and found to be in safe condition for the transportation of passengers and
is clean and free of body damage and is well painted and maintained.
Approved for Use: Yes No
Inspecting Mechanic Signature:
Date:
Inspecting Mechanic Name: (Please Print)
Additional Comments/Remarks:
City of Hudson
Taxi Cab Inspection
Report
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