Incident Report Form
Your name
First Name
Last Name
Date
-
Month
-
Day
Year
Time
Hour Minutes
AM
PM
AM/PM Option
Type of Incident
Crash
Injury
Customer Issue
Vehicle
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Crash
Please describe crash involving a CAT vehicle or other property.
Driver
Vehicle Number
Where did incident occur (Street & Cross Streets, Transit Center, etc.)
Upload photos of crash damage
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If crash, upload photo of license and insurance of involved party
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Invovled Parties/Passengers/Wintess
Please describe the accident/incident
Draw Arial View of Incident/Accident
Upload physical accident/incident or any other related documents
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Injury
Please report any injury or potential injury that was incurred by a rider or employee.
Please describe how the injury or potential injury occurred.
What is the injury?
Was medical attention requested?
Yes
No
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Customer Incident
Please describe any customer related incident that occurred on a CAT bus or facility.
Where did the incident occur?
What happened?
Were the police called?
Yes
No
Employees involved
Type a question
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Vehicle
Please describe the breakdown or other vehicle related incident (non-crash) that occurred.
What happened?
Any additional action required?
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Thank you for your report. You will be contacted if further information is required.
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