PLEASE CONTACT THE FOLLOWING CONTRACTOR FOR SCRAP TIRE PICKUP
KILLY’S TIRES
PHONE # 919-609-3975
FAX# 919-552-7314
Killystires@hotmail.com
From: __________________________________________County Schools
Scrap tires were picked up by Killy’s Tires’ representative in the following quantities.
___/___/___Date Contacted
_______# of 11R22.5 tires picked up @$10.00 each
_______# of 265/75R22.5 tires picked up @ $.09 each
___/___/___Pickup Date
Price for Tires
$ ___________
$ ___________
_______# other various sizes @ $.09 each $ ___________
_______# TOTAL NUMBER OF TIRES PICKED UP
TOTAL COST TO CONTRACTOR $ ___________
Transportation Director/Designee Name ____________________________________________
(PLEASE PRINT)
Signature: ________________________________ Date: _________________________
Killy’s Tires Representative: _________________________ Date: _______________________
Please FAX a copy of this completed form to DPI-Transportation Services at (919) 807-3578 and make a copy for the representative when tires are picked up .
Please make any comments or concerns you have about this service in the space below.
Updated February, 2010 http://www.ncbussafety.org/StateForms.html