Studded Tires Authorization Form - Fleet Management Services

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FLEET MANAGEMENT SERVICES 
STUDDED TIRES AUTHORIZATION FORM  
Please complete this form and fax it to: 802‐828‐3886 or email it to your designated Fleet 
management Services (FMS) service technician – email address provided below.  A form must 
be completed for each vehicle which you request to install studded tires.  Upon approval from 
FMS, you may proceed with the tire purchase and install.   
 Name:
• Date:
 Agency:
• Department:
 Plate Number:
• Last 7 of VIN:
 Phone:
• Email:
 Reason for request:
AGREEMENT 
 Assume the cost for the purchase and installation of the studded tires.
 Transport the off‐season tires to FMS in Montpelier for inventory and storage.
 Label the off‐season tires with the unit and plate number of the vehicle.
 Ensure the studded tires are removed from the vehicle by April 1
st
 of each year.
APPROVALS 
_________________________________________   
__________________ 
Agency Appointing Authority or Designee 
Date  
_________________________________________   
__________________ 
Fleet Management Services 
Date 
SERVICE TECHNICIAN CONTACT INFO 
 Chuck Pilette: chuck.pilette@vermont.gov – 802‐828‐3744
 Keith Lance: keith.lance@vermont.gov – 802‐828‐5633
 Andy Cruickshank: andy.cruickshank@vermont.gov – 802‐828‐3748
FMS Office: 7 Green Mountain Drive, Montpelier VT 05620‐4502 •P: 802‐828‐3821 •F: 802‐828‐3886 •E: fleet.services@vermont.gov  

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