Incident Report Form

Incident / Accident Report Form

1: About You.

* Indicates required field

Your Name *

First

Last

Email *

Phone Number *

Full Address *

Are you a customer of Sun-Shine Cleaning Services? *

Please enter your account number *

Name of your Insurers *

Insurance reference number *

Insurers Phone Number *

2: About the Incident

Date of Incident (DD/MM/YY) *

Time of Incident (24hrs) *

Was this reported immediately to us? *

Who was involved? *

Was the incident internal or external? *

Tell us what happened *

Was there any injuries? *

Please detail any injuries (If applicable) *

Was any damage suffered? *

Please detail any damage suffered (If applicable) *

Please Note: If the item damaged is under statutory inspection requirements, we may need further documentation during this process.

How old was this item which suffered damage? *

Has the item been fixed or repaired since fitting? *

Recent repairs - please give full details *

Was this damage malicious? *

If malicious - was this reported to the Police? *

Police incident number (If applicable) *

3: Costs Incurred.

IMPORTANT: In line with our 'Terms of Service' (Section 8), (See below), which you will have agreed too, we pay 100% of all claims where malicious damage / gross negligence has been caused by Sun-Shine Cleaning Services. In any event, three quotes must be obtained which must be provided from legally registered trades people. We will not accept quotes from non legally registered people. Any claims for compensation must be submitted within four months of the event occuring.

''All team members of ‘Sun-Shine Cleaning Services’ take the utmost care when delivering our cleaning and key holding services, it’s a fact of life that occasionally accidents / incidents do happen, ‘Sun-Shine Cleaning Services’ will take no liability for any damages that may occur during the delivery of the service unless through acts of gross negligence i.e., wilful damage in which case, compensation at current market value will be made on the strict understanding any claims for compensation is made within four calendar months from the event occurring. Customers are reminded that no cleaning packages include the cleaning of trinkets / ornaments etc. and as such, we advise these be placed into a safe area by the customer prior to the cleaning process. See: www.sun-shinecleaningservices.com/incident-report-form.html''

Have costs been incurred as a result of this incident? *

Have you obtained three quotes from trades persons? *

1: Trade Business Name *

Business registration number *

2: Trade Business Name *

Business registration number *

3: Trade Business Name *

Business registration number *

4: The Next Step

We will now process the information you have given and confirm the trades persons you have submitted are legally registered to undertake any works. This process may take up to 10 days but will not exceed 14 days in any event. As stated in our 'Terms of Service', liability is only accepted through acts of malicious damage or gross negligence by Sun-Shine Cleaning Services. In any event; we will respond upon conclusion of both our internal investigation and trades vetting processes. Please provide images of the damaged item(s).

Photo 1 *

Max file size: 20MB

Photo 2 *

Max file size: 20MB

Photo 3 *

Max file size: 20MB

Photo 4 *

Max file size: 20MB

Submit this Incident Form