Free Simple Damage Documentation Template
SIMPLE DAMAGE DOCUMENTATION
I. Damage Documentation Details
|
Field |
Details |
|---|---|
|
Date of Incident |
November 15, 2055 |
|
Location of Damage |
[Your Company Address] |
|
Name of Person Reporting the Damage |
[Your Name] |
|
|
[Your Email] |
|
Phone Number |
555 222 7777 |
II. Damage Description
|
Item Affected |
Damage Description |
Action Needed |
|---|---|---|
|
Shelving Unit #12 |
Destroyed |
Replacement required |
|
Box #245-A |
Contents damaged (fragile goods) |
Inspection and possible replacement |
|
Forklift Unit #3 |
Minor scratches on the exterior |
Inspection and minor repairs |
|
Warehouse Wall |
Minor dents and scratches |
Minor repairs |
III. Cause of Damage
|
Cause |
Details |
|---|---|
|
Operator Error |
The forklift driver attempted to maneuver too quickly in a narrow aisle. |
IV. Immediate Actions Taken
|
Action Taken |
Details |
|---|---|
|
Area Secured |
The area was cordoned off to prevent further incidents. |
|
Goods Relocated |
Damaged goods were moved to a safe location for inspection. |
|
Forklift Inspected |
The forklift underwent immediate inspection for safety. |
|
Temporary Shelving Support |
Temporary support was added to shelving units to prevent further collapse. |
V. Estimated Repair/Replacement Costs
|
Item |
Estimated Cost |
|---|---|
|
Shelving Unit Replacement |
$1,200 |
|
Damaged Goods |
$1,000 |
|
Forklift Repair |
$500 |
|
Warehouse Wall Repair |
$300 |
|
Total |
$3,000 |
VI. Insurance Information
|
Field |
Details |
|---|---|
|
Insurance Provider |
[Your Company Name] Insurance Co. |
|
Policy Number |
123 456 |
|
Claim Number |
9876 |
VII. Attachments (Photos, Reports, etc.)
|
Attachment |
Details |
|---|---|
|
Photos of Damage |
Photos of damaged shelves, forklift, and warehouse wall. |
|
Incident Report |
An incident report from the forklift operator. |
|
Inspection Report |
Warehouse inspection report. |
This template is fully customizable and editable to suit your specific needs. You can fill in the details directly in the template and modify it according to the situation.
