Sample Memo to DivDistrict Safety Coordinators (10-03)

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					                                                     Florida Department of
Memorandum                                  Environmental Protection
                                          Sample
                   Memo to Division/District Safety Program Coordinator


   To:           Division/District Safety Program Coordinator

   From:         {your name and title}

   Date:

   Subject:      General Liability/Automobile/Watercraft Accident and/or Loss Report
                 Location of Accident: _____________________________________
                 ______________________________________________________
                 Division/District Location Code: _____________________________

                 **Complete only if applicable:
                 DEP Vehicle/Boat Property Number: _________________________
                 Driver’s Name: __________________________________________

           In accordance with Directives DEP 355 and DEP 630, attached are the General
   Liability/accident and/or Loss Report Form(s) for the above equipment, which was
   involved in an accident.

           If you have any questions please contact me at {insert your telephone number}.

   Cc:     Department Safety Coordinator

				
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