WEEKLY TIME SHEET

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Engineering Service Road Safety Unit Personal Injury Collision Search Request Contact Name Company Name Company Address Date For Office Use Only Date Sent DM: Post Code Contact Email Address Results will be released to this E-mail Address. Delete as applicable 3 5 Years Study Period Required Location(s) Please attach a plan of all locations ensuring that the search length is clearly marked. Details Please note - At this time it is not possible to provide collision plots or mapping, electronically or via paper copy. Please Tick As Appropriate VAT Receipt Required Yes No Please indicate the reason for the request and what the data will be used for. Cost is based on the size and complexity of the search area. One or more to apply. Basic Search £108 + VAT Large Search £215 + VAT Single stretch of road Maximum 4 junctions (inc) not including end junctions Road length no greater than 1000 metres More than one road 5 or more junctions (inc) along its length not including end junctions Road length greater than 1000 metres Please email a copy of the search area to the address below for costing if unsure. £ Cost of Searches £ Total Number of Searches Plus VAT @ 15% £ Total Amount Due Please post a cheque for the full amount made payable to ‘Cheshire County Council’ with this form and relevant plans for the attention of Kim Barnes at: Road Safety Unit Engineering Service Cheshire County Council Backford Hall Backford Cheshire, CH1 6EA Tel: 01244 973933 Please note - We are unable to release data until payment is received. For queries please contact Kim Barnes by mail, phone or E-mail: kimberley.barnes@cheshire.gov.uk Cheshire County Council cannot be held responsible for the quality and accuracy of the data being provided by Cheshire Constabulary at this time.

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