&1J4~ - City of Glendale

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AUTOMOBILE FOR HIRE, NON-EMEiWENCY MEDlCAL
TRANSPORTATi:ON, DIAL-A-RIDE AND JnNEV SERVICES
Ple(!sc t'ypt 0/' clearly priflt 011 tllis fomr. F91111 (lvai/aul.c ill Microsoft Worljormat 011 ;cquest.
INCOA1.PLETE APPLICATIONS WILL .NOT BE ACCEPTED.
ALL INFORMATION
REQWRED LNTllIS APPLlC!lTION MlISTBE INCLUDliDAT TIME OF st)BMITTAL, •
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:COMPA"Y:lNFORMATION ~~:': ,.' t ... :i . ~,;:; .~\~'Vli.::~\"·I.:.*h·:f~·'···~F:~' :'. {': .: .... "'~;t~f;(>~1.iJi~~·~
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Name of .company: G&S Transit Mi:maqement Inc. dba City Cab
Stree t Ad ~lress; 7955 San Fe rnando Road
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City, Sta~e Z[P: Sun Valley , CA
Phone Number: 818-252-1670
Provi4 .er Type:
o Non-Emergency ~1edical
o Automobile-.For-Hire
O)ihiey
Company· QWllcrsltip:
x~ Corporation
o PartnersHip
9135.2
I FaxNumber:Sllr 252-1607
QTaxicab
o Dial:.-lUde
. . O ·Sole Proprietorship
o Othe~ (please describe):
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