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1-833-463-FAST (3278)
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Formtest
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2023-03-13T13:56:30+00:00
Report Information
Report Date
*
Company
*
Exchange
*
Billing #
*
Cable Located Requested?
*
Yes
No
Locate Completed
*
Yes
No
If locate not completed, why?
*
Damage Information
Damage Reported By
*
Type of Cable
*
Buried
Aerial
Location and Description of Damage.
*
Photos Attached
*
Yes
No
Upload Photos
*
Drag and Drop (or)
Choose Files
Damage Caused By
*
Date of Damage
*
Signature
Date
Contractor Name
*
Damager Address
*
Fastwyre Repair Information
Description of Material/Equipment Used
Quantity
Labor Required
Date
Employee
Reg Hours
OT Hours
Rental EQ Description
# of Hours
Hourly Rate
Was Outside Contractor Used for Repairs?
*
Yes
No
Repair Cost
*
Fastwyre Contractor Info
*
Air Fare Needed
*
Yes
No
Air Fare Cost
Per Diem Cost
Is Repaired Work Temporary or Permanent
*
Yes
No
Fastwyre Repair Information
Description of Material/Equipment Used
Quantity
Labor Required
Date
Employee
Reg Hours
OT Hours
Rental EQ Description
# of Hours
Hourly Rate
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