UTAH DEPARTMENT OF TRANSPORTATION 10. Owner of property damaged and address of owner. 11. Year, make, model, serial number, license number of vehicle. 12. Names of other party's insurance company(s). 13. Witnesses' statements or accounts of accident. 14. Names, addresses, occupations of company personnel involved in accident and how involved. 15. Fully describe details of incident to answer the basic how, when, why questions. 16. Name and identification of person completing report. 17. Signature of Contractor's safety representative. 18. Any photographs if possible.
4.5
Accident Investigating Guide
These guidelines are provided to assist personnel in completing required company forms and conducting effective and complete investigations, determining causes and implementing necessary remedial action. 4.5.1
Implementation
1.
Injured Employee(s)
Personal information about the injured employee(s) should include: a. Name b. Employer c. Age d. Occupation e. Residence f.
Home Phone Number
g. The Insured’s direct supervisor
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