Towing Consent Form
1. Tow operators and tow truck drivers must follow the requirements of the
Towing and Storage Safety and Enforcement Act, 2021. The Act sets out responsibilities for the operation of a tow truck, conduct toward the public and at the scene of an accident, and the rates that can be charged for towing a motor vehicle. The Act also sets out rights you have when requesting or receiving towing services.
2. You have the right to,
(a) decide who can tow your vehicle and where your vehicle will be towed to;
(b) receive and review the Consent to Tow form and Maximum Rate Schedule before towing begins; do not sign a blank form;
(c) receive an unaltered copy of the signed Consent to Tow form;
(d) receive an itemized invoice before paying and get a receipt when you pay;
(e) choose the payment method; and
(f) contact the Ministry of Transportation if you have any concerns about the towing services you receive or the conduct of the tow truck driver or tow operator.
3. Tow truck drivers and tow operators must,
(a) notify you if your vehicle is taken to a location that is different from the location you identified;
(b) not charge more than the rates published on the Government of Ontario’s website on the Towing and Storage Safety and Enforcement Act, 2021;
(c) accept multiple forms of payment;
(d) not solicit you to consent to other services, including vehicle storage services;
(e) not refer you to any medical or legal services and can only refer you to another towing, vehicle storage or vehicle repair business if you request it; and
(f) disclose any interest they have or benefit they may receive from the referral at the time of making the referral.
4. Tow truck drivers and tow operators are identified by name and certificate number on the Consent to Tow form and on the tow truck. Make sure the tow operator’s name and certificate number on the tow truck matches the documentation.
5. Tow truck drivers and tow operators are subject to a Code of Conduct. See the Government of Ontario’s website on the Towing and Storage Safety and Enforcement Act, 2021.
The following form is to provide you expressed consent for Elbert Bloemendal dba Bert's Repair Service to tow your vehicle as outlined below in the form. You are also acknowledging with this form you have been provided access to our Maximum Rates, Operator and Storage License and your rights under the TSSEA.
Bert's Repair Service
22463 Adelaide Road
Mt Brydges, ON N0L 1W0
519-264-2030
bertsrepairservice@hotmail.com
Customer First Name & Last Name
Customer Address
Customer Phone Number
Customer Email
Vehicle Information Include Make, Model, Colour, License Plate and Vehicle Identification Number
Pick up location of vehicle
Drop off location of vehicle
What service are you requesting? i.e tow, winch, tire change, boost, recovery, etc. Please indicate all services requested.
Disclosure of Interest- Bert's Repair Service owns and operates the repair facility Bert's Repair Service. It does not have an interest in any other repair or storage facilities.
If consent is in person please fill request the following information from the tow driver- If not in person consent please indicate over phone in the boxes below
Tow Driver's Full Name
Tow Driver's TSSEA Number
Date consent is being given
Time of Consent
"You must be informed of your rights before you sign this Consent to Tow Form" O. Reg 167/23 s. 33 (1); O. Reg 167/23, s. 41 (1)
Are you giving consent in person at the scene of the vehicle
Yes No
Are you providing this form to confirm your verbal/over the phone consent to tow your vehicle
Yes No
By signing my full name below I confirm I am providing this as an electronic signature confirming my agreement and receipt of all the above information
If Storage is being requested as well, please fill out the following section
Storage Consent
By signing my full name below I confirm I am providing this an as electronic signature confirming my agreement to have Bert's Repair Service tow my vehicle to their storage compound until I provide my consent to release
Click below to submit Form
