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Vehicle Incident Report

This form is used by City of St. Catharines employees when a City vehicle is found to be damaged (i.e. broken window, scratches, dents in bumper or body). If the vehicle was involved in a collision with another vehicle, please use the Vehicle Collision Report.

Once this report is submitted, it will go directly to the Equipment Operator Trainer, Health and Safety Consultant and Manager of Realty and Insurance Service.

Location of Incident

Date of Incident

Time of Incident

City Vehicle

Vehicle Number

Vehicle Type

Year and Make and Model of Vehicle

VIN Number

Plate Number

Driver's Full Name

Driver's License Number

Driver's Full Address (Street, City, Postal Code)

Describe Damage to City Vehicle:

If available, please attach up to five different images of the damage:

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How was the Damage Caused:

Was a police report completed?

Yes

Police report attached?

Yes

Name of Officer

Badge Number

Report Number

Did you attend a Collision Reporting Centre?

Yes

Collision Reporting Centre report attached?

Yes

Date of attending Collision Reporting Centre

Time of attending Collision Reporting Centre

If available, upload Police report or Collision Reporting Centre report.

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Report Completed by

Date Completed

The personal information collected on this Incident Form is collected under authority of Municipal Act. This information will be used for the purposes of documenting vehicle incidents and any necessary follow-up as may be required in accordance with said legislation. Questions about the collection of personal information should be directed to the Office of the City Clerk, or reached at 905-688-5601 ext. 1569 or privacy@stcatharines.ca.

Questions specific to the Municipal Freedom of Information and Protection of Privacy Act, can be directed to the Office of the Clerk (905) 688-5601 ext. 1569 or privacy@stcatharines.ca.