Driver Name: Vehicle Reg:
    Date: // Site:

    Photo Upload

    Damage

    Front
    Rear


    Nearside


    Offside

    Additional Comments

    Checked by:

    Was there another vehicle involved?
    Was there damaged cause to public/private property?
    Who is considered at fault?
    Estimated speed of this vehicle during damage
    mph

    Driver Liability

    If not already done so, please kindly pass your device over to the Driver to allow them to look over the above and confirm all is correct

    Terms & Conditions

    All information above will be reviewed, if you are considered at fault for the damage then a quote/invoice will be provided within the next 30 days. If we need further information then a member of the team will be in contact and we will try our best to keep you updated throughout the process. All terms and conditions of your hire agreement can be found within your original hire agreement that may have been emailed to you, if you would like a copy of this please ask your On Site Manager and we will provide a copy within 5 business days.

    We will evaluate the damage costs before considering insurance, please be reminded that there is an excess of up to £2500.

    By signing the below you agree to the above terms and confirm the information provided is correct. A member of the fleet team will be in touch with either yourself or the On Site Manager to resolve. Thank you.

    Print Name:

    Date:

    Sign:

    Thank You

    Please pass the device back to the On Site Manager to submit the form