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25J - AGMT - SENIOR MOBILITY PROGRAM
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05/16/2011
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25J - AGMT - SENIOR MOBILITY PROGRAM
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Last modified
1/3/2012 3:45:04 PM
Creation date
5/12/2011 11:25:08 AM
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City Clerk
Doc Type
Agenda Packet
Item #
25J
Date
5/16/2011
Destruction Year
2016
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Attachment 1 <br />Pre- Operation Inspection & Defect Report <br />Bus:'Van No. Date: <br />Federal Regulations state that no motor vehicle carrying passengers for hire <br />shat be dnven unless the driver has determined that the /plowing parts and <br />accessories are in good working order. Each driver is required to sutirt a <br />signed written report daay for each coach driven. <br />fst Driver: <br />Miles Finsh: Miles Start. <br />No Defects. O Defects: 0 Signature: <br />2nd Driver: <br />Miles Finish' PAles Start: <br />No Defects. O Defects: C Signature: <br />Miles Elapsed. <br />Miles Elapsed: <br />3rd Dever <br />Miles Finish: Miles Start: <br />No Defects. O Deleets: 0 Signature. <br />Miles Elapsed <br />PREOPERATIONS INSPECTIONS <br />indreare with art (x) that each item has been checked: <br />AM/PM AMlPM <br />_ Tires/Lug Nuts (wheels d rims) Emergency Reflectors <br />Motor-Guard Turn Signal SvAch/Hom <br />_!_ Air System <br />- <br />- First Aid KA <br />Lights/Ref actors 1 <br />- Radio <br />Wheelchair Lifts / 0mves SeaUBelt <br />Wheelchair Lift Cover _/_ Door Interlock <br />-1- Mirrors / W/C Tie Down Straps <br />windshield Wipe rsMashers -I- <br />- Manuel Lin Bar <br />Fire Extinguisher Conduct Walk Around <br />Steering Mechanism Parkir4Brakes/Servtce <br /> Brakes <br />DEFECTS: Indcate with an (x) defective items or#: (Explain in Detalo <br />law? RETARQER ENGINE <br />_ Brake Fluid Leaks _ Light On: _ Hot Engine/Water Leaks <br />_ Soft/Kard Brakes Not Appled - Low 011100 Leaks <br />_ Pug to L/R _ Light On _ Starts Hard <br />_ Dragging Brakes Appled. _ No Power/Eng, Ck. Light <br />_ Smoking Bus Stopped _ Smokes <br />Emergency Brake _ Light Not On: _ idles Rough/Vibration <br />_ Other - expian Brakes Appied. _ Exhaust, Vacuum Leaks <br />nRES/WNEELS Bus Moving _ Fuel Leaks/LPG/Gas <br />_ Flat ArC s 14CA C - Other-expief1 <br />_ Embedded Object _ Oft _TRAN£? UISrON <br />_ Cut _ Too Cold/Ho( _ Won't Go Into Gear <br />_ Smooth/Cord _ Defroster Defect _ SlipsrGrinds/Lurches <br />_ LF RF W1 RRO LRI LRO _ Ventilation (Bklwers) _ Excesaw Norse <br />_ Loose Missing Lugs _ Fumes _ Leaks <br />_ Other - explain - Other- elan _ Onve Lune Vibration <br />L l atmMyC 2rtT poORSr _ Rear End Noise <br />_ Interior )a4N_DO STEERING <br />_ Exterior - Slow _ Hard/Birds <br />_ Location lrq-ative _ Shimmy <br /> _ leaks Air _ Excessive Play <br />VEHICLE CLFANCINESS - Excessive Play Other . vow <br />inlerOr ?w - wow <br />- Exte-nor Emergency Releases _ Generatoostaner <br />Floor WHEELCHAIR FT _ Turn SignatsrFiasfws <br />_ Windows Will Not Fold Out Horn <br />Seal Condition Will Not Lower/Ratse Fare Bok <br />:rpiatn: No ReWaint D-rA.ip _ Instruments/Gauges <br /> Lift Will Not Fold Into _ Fuel. Oct. Arnp Meter <br /> Bus <br />_ Seats _ Handrails _ Modesty Panels <br />l3UUY UAMAUt: <br />Circle and describe any damage to a bus on d+agram <br />of fronUrear and two sloe views <br />O Description <br />0 <br />L100 Pq Description <br />it= Description <br /> <br />Description <br />OPERATOR(S): <br />IMPORTANT! Help expedite repairs by providing necessary <br />information regarding defects' Please print <br />REPAIRS MADE: <br />ALL ITEMS COMPLETED - BUS SERVICED ANO RELEASED: <br />Supervisor's Signature Date <br />25J-34
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