Company Vehicle Incident Report

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I. General Information

Company Name: [Your Company Name]
Department: [Your Department]
Report Prepared By: [Your Name], Fleet Manager

Incident Report Number: CVIR-2024-05-001
Date of Report: May 20,2054

II. Incident Details

Date of Incident: May 18, 2054
Time of Incident: 2:30 PM
Location of Incident: Intersection of Main St. and 5th Ave, Springfield

III. Vehicle Information

Vehicle Make and Model: Ford Transit 2022
Vehicle License Plate Number: ABC-1234
Driver's Name: Jane Smith
Driver's License Number: D12345678
Driver's Contact Information: (555) 123-4567

IV. Incident Description

On May 18, 2054, at approximately 2:30 PM, the company vehicle driven by Jane Smith was involved in a collision at the intersection of Main St. and 5th Ave in Springfield. According to the driver, she was traveling north on Main St. when another vehicle, a Honda Civic, ran a red light from 5th Ave and struck the company vehicle on the passenger side. The impact caused significant damage to the side panel and the rear bumper of the Ford Transit. Weather conditions were clear and the road was dry at the time of the incident.

V. Witness Information

Witness Name: Mark Johnson

Witness Statement:

Mark Johnson, who was walking on the sidewalk near the intersection, stated that he saw the Honda Civic run the red light before colliding with the company vehicle. He confirmed that the Ford Transit had the right of way.

VI. Damage Assessment

Damage to Company Vehicle:

• Description of Damage: Significant damage to the passenger side panel and rear bumper.

• Estimated Repair Cost: $3,000

Damage to Other Vehicle(s) or Property:

• Description of Damage: The Honda Civic sustained front-end damage.

• Estimated Repair Cost: Not assessed by our company.

VII. Police Report

• Police Report Filed: Yes

• Police Report Number: 2024-05-18-SPD

• Officer’s Name and Badge Number: Officer Emily Brown, Badge #5678

VIII. Immediate Actions Taken

Immediate Actions:

• Contacted emergency services and reported the incident.

• Notified supervisor and fleet management department.

• Arranged for the vehicle to be towed to the nearest repair shop.

• Collected witness statements and took photographs of the damage and the scene.

IX. Follow-Up Actions

Follow-Up Actions:

• Contact insurance company to file a claim.

• Schedule a detailed vehicle inspection and obtain repair estimates.

• Review the driver's account and check for any potential driver safety training needs.

• Conduct a meeting with the fleet management team to discuss the incident and preventive measures.

X. Preventive Measures

• Implement a refresher course on defensive driving techniques for all drivers.

• Install dash cameras in all company vehicles to provide clear evidence in case of future incidents.

• Review and reinforce the importance of adherence to traffic signals and awareness of surroundings.

XI. Signatures

Name: [Driver's Name]

Date: [Date Signed]

Name: [Supervisor's Name]
Date: [Date Signed]

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Notes:

• Ensure all sections are filled out accurately.

• Attach any additional documents such as photos, police reports, or witness statements.

• Keep a copy of this report for your records and submit the original to the designated department or individual.

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