*required field 
Tow company invoice number
Email Address*
Invoice date
Service provider / Payee information and claim details 
Supplier / Payee name*
Vendor number*
Storage only/
Individual service billing
GST registrant number*
Supplier type*
Off-site salvage facility 
Claim number (AB99999-0) *
Keys with vehicle?*
Tow bid
Recovery scene photos submitted?*
Towed vehicle
Plate number*
Year*
VIN*
Make*
Model*
Colour*
GVWR
Vehicle category*
This is a Motorcycle
Tow distance
First tow km*
Truck no.
Date of tow*
Hookup rate
Per km rate
Location or address of pickup*
Location or address of drop off*
Date of tow
Date of tow
FUEL SURCHARGE
Fuel surcharge percent* 
%
Fuel surcharge 
Storage and assessment
Storage zone (rates listed are per day): 
Zone 1 (T&R+ $24.7; Base: $20.95)
Zone 2 (T&R+ $23.58; Base: $19.85)
Zone 3 (T&R+ $21.33; Base: $16.54)
Zone 4 (T&R+ $16.84; Base: $12.12)
Vehicle length:
*
Storage From
*
To
*
No. of days
Additional services  Loading and securing, clean up, recovery, standby, airbrakes/axle/driveshaft removal and consumables.
To submit expenses in this section, supporting photos must be submitted to ICBC.
Select each service that was required from the list below.
Loading and securing Loading and securing time needed
Clean up Clean up time needed
Recovery Recovery time needed
Standby Standby time needed
Airbrakes/Axle/Driveshaft removal Airbrakes/Axle/Driveshaft removal needed
Consumables used (flares, oil absorbent, tarps/covers, protection wrap etc.)
FUEL SURCHARGE
Applies to loading/securing, cleanup, recovery, standby, and Airbrakes/Axle/Driveshaft removal  costs only
Fuel surcharge percent
%
Fuel surcharge 
Additional supportExtra person, recovery scene coordinator, additional truck / service, rotator, tri-drive, company owned/leased equipment.
Extra person 
Recovery scene coordinator 
Additional truck (service) 
Heavy Duty Rotator 
Heavy Duty Tri-Drive 
Company Owned/Leased Equipment
FUEL SURCHARGE
Applies to additional truck regular/service, heavy-duty rotator, and heavy-duty tri-drive only
Fuel surcharge percent
%
Fuel surcharge 
Sublet servicesTraffic management/flag persons, environmental, third party rentals, biohazard, another tow company etc.
Sublet required (including owned equipment)
Other charges
Additional Information Field 
Provide any feedback/comments or additional details that are applicable to this invoice. 
Cost summary