ROADSIDE ASSISTANCE CONTRACTOR APPLICATION
Thank you for your interest in becoming a Roadside Assistance provider for AAA - The Auto Club Group (ACG). AAA has been the premier motor club for over 100 years. At ACG, we help our members enjoy life's journey with peace of mind, by providing innovative solutions, advocacy and membership benefits wherever and whenever they need them.
There is a lot more that comes with a contract with AAA than just prestige. You may take advantage of various collateral benefits and opportunities for your business that can be derived from rendering service to AAA Members. You can also take advantage of discounts and savings from national partners like Ford, NAPA, AW Direct, Cintas and Santander Bank, just to name a few.
Our multi-faceted digital dispatch system provides several options for receiving AAA calls. They can be received at your office computer, directly on mobile devices or delivered to the closest truck to the breakdown location with our Auto Vehicle Locator (AVL) technology. This same system provides you with the ability to manage and clear those calls real time. You can also view your weekly pay statement online while enjoying the ease of payment via Electronic Funds Transfer (EFT), which are deposited each week for calls that were run the week prior.
To begin your journey with ACG, please complete and submit the contractor application below. We will contact with you within 10 business days of receiving these items with your next steps.
Name of company
Ownership structure
Business address
City
State
Zip
Name of owner/s (please include any partners or corporate officers)
Email
Website
Telephone
(Day)
(Night)
(24-Hr)
1. Do you provide 24-Hour service?
2. Have you ever held a AAA contract before?
3. Do you conduct background checks on your employees?
4. Do you conduct drug testing on your employees?
5. Are you contracted with Police, D.O.T. or County rotations?
6. Are you contracted with other motor clubs?
7. Do you provide salvage or repossession work?
No
No
No
No
No
No
No
8. How many years in business?
9. How many employees?
10. Do you have a repair facility?
Name of insurance carrier
Address
Agent
Phone
Please list coverage Amounts
A. Commercial Garage/General Liability
B. Commercial Auto Liability
C. Garage Keeper
D. On Hook/Cargo (Tow Only Providers)
E. Workers Compensation (where required)
1. If ACG elects to move forward with the application process after your application has been reviewed, we will provide more detailed information on our insurance requirements.
2. Prior to entering any contractual agreement with AAA – The Auto Club Group, ACG will require submission of a fully compliant certificate of insurance (COI), including ACG as certificate holder and additional insured. More details will be provided, if ACG elects to move forward with the application process.
In the event of a member’s complaint to AAA, will you cooperate fully in any investigation and decision of AAA?
No
Services you provide:
1. Locksmith
2. Light Service Only (tire changes, jump starts, lockouts, etc.)
3. Light Duty Towing (passenger vehicles)
4. Motorcycle Towing
5. Do you have dollies
6. Medium Duty Towing (10,001 to 26,000 lbs GVWR and with 6 tires or more)
7. Heavy Duty Towing (26,001 lbs or more GVWR and with 6 tires or more)
No
No
No
No
No
No
No
Description of service vehicles.
Please add vehicles below by clicking the Add a Vehicle button.
Coverage Area: List those cities/towns that you can maintain a 45-minute or less average arrival time.
Please list industry specific certifications and awards:
The undersigned hereby makes this application for appointment as an official Roadside Assistance service contractor of AAA - The Auto Club Group (ACG) to render Roadside Assistance service to AAA Members and submits the information herein as being true and correct as a basis for consideration of this application. By making this application, I certify that the company listed is fully licensed and registered to operate within the state(s) identified in this application. If my facility is located outside of ACG’s operating territory, I hereby expressly give ACG permission to provide this application and all of the information contained therein to the AAA Club that operates within the territory where my facility is located.
If ACG wishes to move forward with the application process after reviewing this application, I understand that I will be contacted for additional required information and will be required to execute a formal contract before services can be provided. In making this application for a Roadside Assistance service contract, it is understood that ACG may investigate, or have an outside agency investigate, the personal and business background of any individuals listed or found to be partners or officers of the company desiring a contract and obtain information concerning retail credit history from credit reporting agencies and financial institutions. It is understood and agreed that the information discovered is confidential and may not be disclosed to the applicant.
It is understood and agreed that the submission of this application does not guarantee a Roadside Assistance service contract with ACG or any other AAA Club and that a contract for services is offered at the sole discretion of ACG or the applicable AAA Club.
I intend the electronic signature below to operate as my formal signature with the same force and effect as a physical signature. By signing this application, I certify that I have the authority to act on behalf of the company listed in this application and that all information provided is true and accurate to the best of my knowledge.
Name
Date
