EXHIBIT B
TOWING ROTATION APPLICATION
Please complete the following and mail or deliver to: Hays County Sheriff’s Office
Traffic Division,
1307 Uhland Road
San Marcos, TX 78666
Company NameCompany Address
Company Phone / Alternate Phone / Mobile
Fax / Pager / Email
Owner/Principal Full Name / DOB / TDL
Driver Full Name / DOB / TDL
Driver Full Name / DOB / TDL
Driver Full Name / DOB / TDL
Driver Full Name / DOB / TDL
*Insurance Company Name / Telephone Number / Policy Number
Make/Model/Class (A,B,C) / Year / VIN#
Truck #1
Truck #2
Truck #3
Truck #4
*Copy of Insurance documentation must be submitted with the application
Service District/Tow Service applying for (circle below for each section):
SAN MARCOS· IH 35 NORTH TO YARRINGTON RD. – CR 159
· EAST HWY 21 TO CR 159
· NORTH POST RD TO BLANCO RIVER
· RR12 TO CR 214
· CR 213 TO HILLIARD RD / KYLE/BUDA
· IH 35 NORTH OF YARRINGTON RD TO COUNTY LINE
· NORTH ON FM 150 TO ONION CREEK
· WEST ON FM 3237 TO RR12
· WEST ON CR 183 TO CR 221
· WEST ON FM 967 TO FM 1826 / DRIPPING SPRINGS
· FM 150 TO ONION CREEK
· FM 1826 TO COUNTY LINE
· RR12 TO CR 170 / WIMBERLEY
· RR12 TO RR32
· RR32 TO COUNTY LINE
· RR12 TO CR 170
· FM 3237 TO FM 150
· MT. SHARP TO E. MT GAYNOR
Towing Rotation – Class A/B Trucks
YES NO / YES NO / YES NO / YES NO
Heavy Rotation – Class C Trucks
YES NO / YES NO / YES NO / YES NO
Optional Motorist Assist Rotation
YES NO / YES NO / YES NO / YES NO
I hereby authorize the Hays County Sheriff’s Office to conduct a criminal background check through TCIC/NCIC:
Criminal History Checked
Owner Printed NameSignature
Driver #1 Printed Name
Signature
Driver #2 Printed Name
Signature
Driver #3 Printed Name
Signature
Driver #4 Printed Name
Signature
☐
☐
☐
☐
☐
STATE OF TEXAS
COUNTY OF ______
☐New Application ☐Renewal Application ☐Reinstatement
This instrument (Hays County Sheriff’s Office Wrecker Policy) consisting of ______pages was received on ______(date) by ______(name of acknowledging partner or partners), partner(s) on behalf of ______(name of partnership), a partnership. I agree to abide by the rules and regulations set forth in this document. I they have read through the document and any attachments carefully. I attest
· The facts contained in the document are true,
· I am expressly authorized to sign the document,
· I understand the consequences of making a false statement will result in termination of this contract with Hays County.
· I understand that this is a government record and will be considered as such for any false statements.
______
Signature Date
******************************************************************************
Notary
The foregoing instrument was acknowledged before me this _____ day of ______, 20____,
by ______.
______
Notary Public Signature Notary Public Name My commission expires
(Notary Seal)
******************************************************************************
Date Received: ______HCSO Rep receiving application:______
☐Application Accepted ☐Application Rejected
Notes:______
Page 2 of 4