Title Page

  • Reported By:

  • Title:

  • Line Manager/Exco Member:

  • Date Reported:

Details of Damage

  • 1. Actual date of damage:

  • 2. Actual time of damage (exact time that the network/infrastructure damaged):

  • 3. Reason we became aware of the damage (clients downtime/NOC alert etc.)

  • 4. NOC Report: (attach from active team)

  • 5. Actual time arrived on site:

  • 6. Actual address of damage and GPS coordinates:

  • 7. Who was on site upon arrival? (Contractors / Third Parties / Witnesses)

  • 8. Contact details and particulars of anyone on site:

  • 9. Structured details of damage on site:

  • 10. Who is the liable party? and why?

  • 11. Details of liable party (Company/Individual name, address, contact details, project manager, subcontractors and main contractor details)

  • 12. What is the severity of the damage?

  • 13. How many services affected? And ISPs that are affected -

  • 14. What work needs to be done to get the network up? (Interim and permanent if applicable)

  • 15. Actual time to diagnose issue:

  • 16. How long will this work take?

  • 17. Cost of damages?

  • 18. Has a SAPS case been opened? If so provide SAPS Cas number and details of investigating officer –

  • 19. Recommendation on mitigating potential further damage:

  • 20. Additional information:

  • 21. Attach the following: (Please mark check box)

  • Pictures of site and damage

  • Reason for "No" Response

  • Pictures of third parties on site

  • Reason for "No" Response

  • Obtain witness statements from neighbors, bystanders and/or third parties

  • Reason for "No" Response

  • Attempt to collect footage

  • Reason for "No" Response

  • Diagram of affected network:

  • Reason for "No" Response

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.