Brake Performance Report Complete the form below and click "Submit" to send to your Centric Parts Sales Representative
Name:	Company:
Email:	Phone:
1. Define Vehicles in Service
Pursuit Vehicles: (Qty.) High Load Driving Vehicles: (Qty.) General Fleet Vehicles: (Qty.)
2. In Service Questions
What brand brake components are currently being used? Brake Problems or complaints?
Performance Rankings (10 = Best)
Noise 1 2 3 4 5 6 7 8 9 10 Wear 1 2 3 4 5 6 7 8 9 10 Fade 1 2 3 4 5 6 7 8 9 10	Cold Stopping Power 1 2 3 4 5 6 7 8 9 10 Hot Stopping Power 1 2 3 4 5 6 7 8 9 10 Overall Performance 1 2 3 4 5 6 7 8 9 10
Typical Service Cycle: Miles Between Services: Estimated Miles Driven Per Year: