VEHICLE ACCIDENT REPORT
Vehicle and Equipment Accident/Damages
This form, or an approved alternate form, must be completed for all accidents involving any City vehicle, equipment (any
item attached to a City Vehicle) or property damage caused by a City vehicle or equipment. Please report any incident
immediately and complete all related sections of this report and provide a copy of Fleet Maintenance within one (1)
business day for processing (pictures of the damages will be required at the time of incident)
Supervisors must be notified immediately by the employee and the incident should be reported to Human Resources
immediately or within one (1) business day of the incident.
This form must be signed by the employee involved and the employee’s supervisor however, if signatures cannot be
obtained within one (1) business day, the form should be forwarded to Fleet Maintenance as soon as possible.
Employee Name: Home Phone #:
Street Number Street Name City State Zip Country
Job Title: Department:
Date of Occurrence: Time of Occurrence:
Address/Location of Occurrence:
Briefly describe accident and how or why it occurred:
Witness’ Name (include address if not a city employee):
Was drug test given?
__No If not, state reason:
SECTION A – GENERAL INFORMATION