Volunteer Fire Company Quotation Form Proposed Transaction Information for Apparatus.
Please TAB from field to field. ENTER or click on SUBMIT button when finished.
Exact Legal Name of Fire Company:
Full Address of Fire Company:
City:
County:
State:
Zip:
Telephone Number of Fire Station:
Contact Person:
Title:
Daytime Phone Number of Contact:
Home Phone Number of Contact:
Fax Number:
Email:
Total Acquisition Cost for Equipment: $
Cash Down Payment: $
Grants: $
County or Relief Association Funds: $
PEMA Loan (Pennsylvania Only): $
Total to Finance: $
Chassis Prepayment Amount: $
Date of Chassis Prepayment:
Amount Due Vendor at Final Delivery: $
Date of Final Delivery:
Equipment Description (Year, Make, Model):
Type of Truck (Rescue, Pumper, Ladder, etc):
Chassis Manufacturer:
Term (Number of years):
Payment:
Select Monthly Annually Quarterly Semi-Annually
Method:
Select Advance Arrears
Enter additional comments or questions in the space provided below: