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Department Name*

Department Address*

Does your vehicle have a pump, multiplex electrical, generator, or power stretcher loading system?*YesNo

Does your vehicle have an aerial/ladder?*YesNo

Is your vehicle Hyrbid or All Electric? *YesNo

Coverage Term for Your Warranty Quote?*6 Months Warranty1 Year Warranty2 Year Warranty3 Year Warranty4 Year Warranty5 Year Warranty6 Year Warranty7 Year Warranty8 Year Warranty9 Year Warranty10 Year Warranty

Where do you get your vehicle serviced?*

Which dealer do you buy your vehicles from?*

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