Fleet Service Request | OCD Diesel, Merrill WI

Company

Legal business nameDoing business as (if different)

Street addressCityStateZIP

Main phoneWebsiteYears in business

USDOT numberMC number (for-hire carriers)Federal tax ID (EIN)

Type of operation For-hire carrier Private fleet Construction / excavation Agriculture / farm Logging / forestry Municipal / government Delivery / service fleet Other:

Contacts

Fleet manager, accounts payable, dispatch, drivers: whoever we should know. Tick Authorize for anyone who can okay repairs, and pick what each person gets from us.

Preferred contact Call Text Email Fleet portal

Locations

Headquarters, terminals, yards, your own shop, job sites: anywhere your units are based or we might pick up or meet them. Notes are for gate codes, hours, where to park, who to ask for.

Unit list

Paste or type a VIN and we'll fill in the year, make, model and engine. Got a spreadsheet? Copy the whole VIN column and paste it into the first VIN box: every unit gets its own card. Add as many units as you have.

Your fleet

Number of units

Heavy-duty (Class 7–8)Medium-duty (Class 4–6)Light-duty / pickupsTrailersEquipment / agOther

Engine makes in the fleet

How often we'd see your units Weekly A few times a month Monthly Quarterly Breakdowns / as needed Not sure yet

Unit list Listed on this form Sending a spreadsheet We'll go over it at the shop

What you need from us

Pm schedule you follow (miles / hours / months)DOT inspections due (month)

What matters most to you Turnaround time Updates while it's here Scheduled PM Price Road service availability Parts on hand Other:

How you'd like updates When it's diagnosed Daily while it's here Only when it's done Other:

Expectations — turnaround, downtime, anything we should know about how you run

Approvals

Who can okay repairs: the people you ticked Authorize for under Contacts.

Approval limit per repair ($) — call before going overOver the limit, call

Approvals by Phone Text Email Fleet portal / PO system

When no one answers Hold the unit until we hear back Go ahead up to the limit Other:

Billing

PO numbers Required on every repair Not required Blanket PO:

Send invoices by Email: Mail to our company address Fleet portal / AP system:

Sales tax Not exempt Exempt (business / farm) Government / municipality

If exempt

Tax ID or CES #Wisconsin S-211 attached?

Wisconsin buyers: download our S-211 with our side already filled in.

Payment Pay at pickup Apply for Net 30 (approved accounts)

Credit references (for Net 30)

BankBranch / cityBank contact & phone

Authorization

I'm authorized to request fleet service for the company named on this form, and the information on it is accurate. For Net 30, OCD Diesel may contact the references listed.

Or type your full namePrinted name & titleDate

Request fleet service.