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Emergency Wrecker Replacement Application Page 2 of 2 <br />I hereby certify that all the statements contained in this application are true and correct to the best <br />of my l�owledge. <br />Indiv iduaf Partner <br />X X <br />Corporation President attested by Corporation Secretary*** <br />***If Corporation, affix corporate seal to this application <br />SWORN AND SUBSCRIBED to before me, the undersigned authority, by the above <br />day of tW� < f [ <br />V. F. TSCHA,PPAT1 �— <br />�$0<. ��n wNolary Public, $tale of Texas ' <br />Cornm.Expires 138-i4-2ofo .: <br />notary it) 1937257 Notary Public for a State of Texas <br />FOR CITY USE ONLY <br />THE FOLLOWING IS REQUIRED BEFORE ANY EXISTING PER1VII'I" IS RE -ISSUED: <br />t Certificate of Insurance with City shown. as Certificate Holder & Wrecker identified <br />Combined Single Limit (CSL) Liability as follows: <br />$300,000.00 - If Gross Vehicle Weight is 26,000 lbs. Or less <br />$500,000.00 - If Gross Vehicle Weight is over 26,000 lbs. <br />Tax Dept. confirmation that the Applicant has no outstanding Taxes <br />_ Accounting confirmation that the Applicant has no outstanding indebtedness <br />Receive LP Police Department Wrecker Inspection Memo <br />(Applies to Emergency Auto Wrecker Permit Only) <br />Permit No. Re -issued: <br />Date Issued: > -7—/ <br />Fee Collected: d-S-1 <br />Receipt Number. - <br />Clerk Utials: <br />City Secretary Provided with Copy of Pernait/License: <br />Date Clerk Initials <br />Police Dept. Provided with Copy of Permit/License: <br />Date Clerk Initials <br />Revision: 07/24/2007 <br />SACity Planning Sharel04-INSPECTIONS DIVISIOMInspectionslEMERCr WRECKER REPLACEMENT APPL ICATIONAm <br />