Independent Operator

  • Business Information

    *required fields
  • Contact Information

  • Add a new row
  • Add a new row
  • Insurance Information

  • Tororoadrunners must be named as certificate holder. Current Insurance Information should be attached for the application to be processed. W-9 form to be completed and attached to the application.
  • Service Information

    Are you open 24 hours?
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  • Facility Information

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  • Repair Hours
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  • Impound/Storage Lot
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  • Equipment Information

  • List your equipment: (Review contract for insurance requirements)
  • DolliesWheel LiftFlatbed 
  • SemiWinchHeavy Duty Vehicle 
  • Service VehicleLandoll/Lowboy 
  • Equipped to handle motorcycles 
  • Equipped to handle RVs 
  • Equipped to handle Manual Lockouts 
  • Equipped to handle Electric Lockouts 
  • Equipped to handle Medium Duty 
  • Area of Coverage

  • The Service Area you will cover is determined by ZIP codes. Please describe your “usual” area of coverage by recording the ZIP code(s) below: Quick (ETAs less than 30 minutes)*
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  • Other ZIP Codes covered*
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  • Please include any additional ZIP codes you cover separately.
  • Owner Information (optional)

  • This field is for validation purposes and should be left unchanged.