Tab 2.2.1 Attachment 5 -SF-91 Accident Report Form.pdf

Vehicle Accident Reporting

Instructions.doc

FFFeeedddeeerrraaalll EEEmmmeeerrrgggeeennncccyyy MMMaaannnaaagggeeemmmeeennnttt AAAgggeeennncccyyy Office of Occupational Safety and Health

Disaster Safety Office

Title: Motor Vehicle Accident Reporting Procedures

When An Accident Happens If you are involved in a vehicle accident please follow these procedures. This includes GSA vehicles, rental vehicles, or your private vehicle while on FEMA business:

1. If possible and it is safe to do so, move vehicles from traffic lanes.

2. DO NOT make any statement that admits guilt or fault to any individuals.

3. If there are any injured parties, request medical assistance if necessary.

4. Call the Police and report the accident.

5. Call your Supervisor as soon as practical. If you cannot reach your Supervisor, call the Disaster Safety

Officer:

6. Obtain as much of the following information as possible:

a) Name, address, phone number, driver’s license number, and issuing state of all involved parties.

b) Name of insurance company with policy number for all involved parties.

c) Make, model and license plate number and state of all involved vehicles.

Vehicle Accident Reporting Procedures A Motor Vehicle Accident Report SF-91 must be filled out for any auto accident occurring during a disaster.

Packets containing the necessary forms will be available at the Safety and Security Office.

1. Required documents:

a) SF 91 Vehicle Accident Report Form

b) Legible Copy of Rental Agreement

c) Copy of Police Accident Report, if any.

d) Copy of Auto Rental Agency Accident Report

2. Be sure to notify the rental company and report the accident. Keep copies of any accident form or other forms that were filled out for the rental company.

3. If major damage occurs, it is recommended that digital photos be taken of the vehicle(s) involved.

4. Make copy for your files and submit the originals to the Safety Department.

5. The involved FEMA employee will be required to fill out a SF-91 “Motor Vehicle Accident Report “ form.

Be sure Block 81a. 81b, 82a, 82b, and 82c in Section X (Supervisor’s Certification) is filled out and signed by Supervisor.

6. Return the completed form to the Safety Department.

7. If employee is contacted about the accident or payment, the FEMA contact is:

FEMA Tort Claims Division 500 C Street SW Suite 840 Washington, DC 20472 202-646-7084

8. A copy of the Accident Report and attached documents will be faxed to Tort Claims and a hard copy will follow in the mail.

APPENDIX D

SF - 91Motor Vehicle Accident Report.