DRIVER OF BT VEHICLE QUESTIONNAIRE
REF: C/457294/SG
DRIVER DETAILS
FULL NAME: Jordan Kirby
FULL HOME ADDRESS:
20 Cleveland Road
Bournemouth
BH1 4QD
BT EMPLOYEE:
YES
IF NO WHAT IS YOUR RELATIONSHIP TO BT EMPLOYEE:
CONTACT DETAILS:HOME: 07435662344
WORK: 07435662344
MOBILE: 07435662344
E-MAIL ADDRESS: Jordan.kirby@openreach.co.uk
WHAT IS YOUR JOB TITLE?
Customer service engineer
HOW LONG HAVE YOU BEEN EMPLOYED BY BT?
1 year 10 months
HOW LONG HAVE YOU BEEN IN YOUR PRESENT JOB?
1 year 10 months
WHAT TYPE OF VEHICLE DO YOU DRIVE?
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1
Ford Transit
DO YOU NEED GLASSES FOR DRIVING? YES
IF YES
WERE YOU WEARING THEM AT THE TIME OF THE
ACCIDENT?
HOW LONG HAVE YOU HELD A FULL DRIVING LICENSE?
2 years 10 months
DO YOU HAVE ANY CURRENT ENDORSEMENTS? NO
IF YES WHAT FOR?
ARE YOU ON ANY MEDICATION THAT CAN CAUSE DROWSINESS?
NO
HAD YOU CONSUMED ANY ALCOHOL OR SUBSTANCE DURING THE 24
HOURS PRIOR TO THE ACCIDENT?
NO
WHAT WAS THE PURPOSE OF YOUR JOURNEY? HOW FAMILIAR
WERE YOU WITH THIS ROUTE? PLEASE PROVIDE FULL DETAILS?
Travelling to job, fairly familiar with the route.
HOW LONG HAVE YOU BEEN IN POSSESSION OF VEHICLE USED AT
TIME OF ACCIDENT?
1 year and 10 months
HOW LONG HAD YOU BEEN WORKING WHEN THE ACCIDENT
OCCURRED?
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5 hours
ACCIDENT DETAILS
PLEASE CONFIRM THE DATE AND TIME OF ACCIDENT:
1/12/14. 1315
PLEASE CONFIRM EXACT LOCATION:
Roundabout of Ham Lane (B3073)/Ringwood Road (A348)
PLEASE GIVE A FULL DETAILED ACCOUNT OF THE SEQUENCE OF
EVENTS BEFORE DURING AND AFTER THE ACCIDENT?
I was in the left hand lane at the roundabout about to turn left, when the
driver in the right hand lane pulled away the rear end of his vehicle
drifted into my lane and scraped the nearside of my van. I continued left
and pulled into the car park of the White Hart Inn on Ringwood Road. I
got out and assessed the damage while the driver of the other vehicle
then came and parked in the same car park.
WERE YOU TRAVELLING, STATIONARY OR SAT IN TRAFFIC?
Transitioning from sat in traffic to travelling
HOW MANY MILES PER HOUR WERE YOU TRAVELLING?
5mph
DID BOTH VEHICLES MAKE CONTACT?
Yes
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AT WHAT POINT WERE YOU AWARE OF THE OTHER VEHICLE?
Whilst sitting in traffic waiting at the roundabout, the other vehicle was
in the next lane.
AT WHAT POINT WERE YOU AWARE OF THE OTHER PARTY’S
INTENTIONS?
When he positioned himself in the right hand lane and pulled away.
DID YOU SOUND OR SIGNAL ANY WARNING?
Signalling left, no horn
IF NOT, WHY NOT?
Was not aware that the rear end of the other driver’s vehicle was drifting
into my lane until contact was made
WHERE DID YOU PULL OVER AFTER THE ACCIDENT?
Car Park of the White Hart Lane on Ringwood Road
DID YOU SEE WHAT DAMAGE HAD BEEN CAUSED TO THE OTHER
VEHICLE? PLEASE PROVIDE FULL DETAILS
No, other driver did not stay long enough for me to assess his damage.
WAS THE THIRD PARTY VEHICLE DRIVEABLE – DID THIRD PARTY
DRIVE AWAY?
Yes
WERE THERE ANY PASSENGERS IN THE THIRD PARTY CAR? YES/NO
Unknown, other driver did not stay long enough
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IF YES, HOW MANY PASSENGERS DID YOU SEE?
WERE THEY INJURED?
PLEASE PROVIDE DESCRIPTION OF PASSENGER(S) AND WHERE
THEY WERE SAT IN THE VEHCILE?
WHAT DID YOU DO TO CHECK IF THERE WERE ANY PASSENGERS?
Unable to check, driver left quickly
WERE THERE ANY WITNESSES TO THE ACCIDENT?
Joe Butler
DID YOU OBTAIN THE WITNESS DETAILS? IF YES PLEASE PROVIDE
Yes –
BT Openreach Apprentice Customer Service Engineer
07423470125
joe.butler@openreach.co.uk
DO YOU KNOW WHAT RELATIONSHIP WAS BETWEEN PASSENGERS
AND THIRD PARTY?
DID YOU OBTAIN ANY CONTACT DETAILS/ INSURANCE DETAILS FOR
THE THIRD PARTY?
Yes
WAS THE THIRD PARTY CO-OPERATIVE?
Gave details but left quickly with no follow up questions
DO YOU KNOW THE OCCUPATION OF THIRD PARTY?
Yes
PLEASE PROVIDE A DESCRIPTION OF THE THIRD PARTY
Male, 30s, 5’10-5’11, medium build, brown with blonde highlights.
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PLEASE PROVIDE DETAILS OF ANY CONVERSATION YOU HAD WITH
THE THIRD PARTY
No conversation, third party was on the phone and handed a piece of
paper with details, did not speak.
DID ANY ASSOCIATED WITH THE THIRD PARTY ARRIVE AT THE
SCENE? PLEASE PROVIDE DETAILS
No
DID THE THIRD PARTY SEEM VERY KNOWLEDGABLE IN THE
PROCESS?
No
WAS ANYONE INJURED?
No
WAS MEDICAL ASSISTANCE REQUIRED?
No
WAS AN AMBULANCE CALLED?
No
DID THE POLICE ATTEND THE SCENE?
No
IF YES, PLEASE PROVIDE THE CAD REFERENCE NUMBER, NAME OF
THE POLICE STATION AND NAME OF POLICE OFFICER ATTENDING?
PLEASE ATTACH SKETCHES OF THE LOCATION SHOWING THE
POSITON OF ALL THE VEHICLES INVOLVED BEFORE, AND THE
POSITION OF THE VEHICLES AFTER THE ACCIDENT.
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IF YOU HAVE PHOTOGRAPHS OR IF YOU ARE ABLE TO OBTAIN
PHOTOGRAPGHS, PLEASE FORWARD COPIES.
WHAT WERE THE WEATHER CONDITIONS AND VISIBILITY AT THE
TIME OF THE ACCIDENT?
Dry and clear
WHO DO YOU FEEL IS AT FAULT FOR THE ACCIDENT AND WHY?
PLEASE PROVIDE FULL DETAILS
The third party is at fault as his vehicle drifted into my lane when he
pulled off. Accident caused by other vehicles long wheel base allowing
the rear end of his vehicle to dangerously drift into my lane.
IF REQUIRED, ARE YOU PREPARED TO ATTEND COURT?
No
IF NOT PLEASE STATE WHY NOT?
Not prepared to go to court on this matter
WAS ANYONE WITH YOU AT THE TIME OF THE ACCIDENT?
Yes
WHO? PLEASE PROVIDE FULL DETAILS AND RELATIONSHIP TO YOU
Joe Butler - Colleague
BT Openreach Apprentice Customer Service Engineer
07423470125
joe.butler@openreach.co.uk
DAMAGE TO YOUR VEHICLE
IF YOU DRIVER A COMMERCIAL LIVERIED VEHICLE PLEASE ANSWER
THE FOLLOWING:To be able to assess the amount of working time lost by you as a result
of this accident, please confirm:{ NOTE: If your vehicle was not repairable (ie a total loss), please still
answer any of the questions which may be relevant below, but confirm
here: TOTAL LOSS YES / NO }
1. Did you take your vehicle to a repairer?
Yes – BT Fleet Nursling
45mins
Cleveland Road to Oriana Way – Home to BT Fleet Nursling
If yes:
how long did it take to drive there?
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Where did you drive from and to?
2. Did you have to unload your vehicle?
Yes – 2 hours
Tools and engineering equipment
If yes:
how long did it take to unload your vehicle?
What did items (a brief description) did you have to unload?
3. How did you return to your place of work?
Hire Vehicle
4. How were you able to continue with your day to day work whilst your
vehicle was being repaired?
Yes
5. When picking your vehicle up from the repairer:
How long did it take to drive there?
How did you travel there?
Where did you travel from and to?
Has not been repaired at this time
6. Did you have to re-load your vehicle?
Have not received repaired vehicle at this time.
If yes:
how long did it take to re-load your vehicle?
Were the items you had to re-load as per Q2 above? If no,
please detail items (a brief description) and
reasons why.
7. Please provide any information regards any other time you believe
was lost as a result of this accident:-
DAMAGE TO THE THIRD PARTY’S VEHICLE
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PLEASE PROVIDE DETAILS OF THE DAMAGE SUSTAINED TO THE
THIRD PARTY’S VEHICLE (include nature of damage, location of
damage and if any pre-existing damage).
No damage seen to 3rd parties vehicle.
PLEASE PROVIDE ANY OTHER INFORMATION YOU FEEL MAY BE
RELEVANT.
Before incident; both vehicles
waiting at roundabout in separate
lanes.
During incident; both vehicles move
off from waiting at traffic, vehicle in
right hand lane to turn off to Ham
Lane strikes vehicle in left hand lane
with rear end of his vehicle.
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