APPLICATION FOR SNOWPLOWING LICENSE
WITHIN THE CITY OF WALKER
DATE: ____________
NAME:______________________________________________PHONE:____________________
COMPANY NAME: ______________________________________________________________
ADDRESS: _____________________________________________________________________
_____________________________________________________________________
NUMBER OF VEHICLES TO BE IN USE:____________________________________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
MAKE__________________
MODEL_________________
LIC. NO. _________________
INSURANCE COMPANY CARRYING COVERAGE ON THE ABOVE____________________
PUBLIC LIABILITY _________________/___________________(Minimum coverage required
$50,000/$100,000)
PROPERTY DAMAGE___________________________________(Minimum coverage $25,000)
CITY OF WALKER MUST BE LISTED AS CO-INSURED ON THE APPLICANT’S POLICY.
EXPIRATION DATE OF POLICY___________________________________________________
Application approved by:
__________________________________________
City Clerk
FEE RECEIVED $_____________________
($30 per truck)
City License Number Issued_______________________ DECALS ISSUED_________________