Instructions for Form 700-010-12 "Utility Conflict and Damage Report" - Florida

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This document contains official instructions for Form 700-010-12, Utility Conflict and Damage Report - a form released and collected by the Florida Department of Transportation. An up-to-date fillable Form 700-010-12 is available for download through this link.

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Instructions for Form 700-010-12 "Utility Conflict and Damage Report" - Florida

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Instructions for Form 700-010-12 "Utility Conflict and Damage Report" - Florida, Page 2

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Instructions for Utility Conflict and Damage Report

(Form # 700-010-12)

(All fields are self-explainable with the exception of the “Drop-down” fields listed below.)

Header Information – Self-Explainable

Part A – Contractor or Agency Involved

Contractor/Agency Information – (Select from

Drop-down list)

Part B – Facility Damaged

Enter dates for Damage Occurred and Damage Repaired – (Select date and time from

Drop-down calendar.) You will need to input appropriate time.

Duration of Outage – Calculates time difference between Damage Occurred and

Damage Repaired. (Example: 2 days, 3 hrs, 35 mins.)

Type of Facility Damaged – (Select from Drop-down list) -

Type of Facility Material Damaged – (Select from Drop-

down list) -

1

Instructions for Utility Conflict and Damage Report

(Form # 700-010-12)

(All fields are self-explainable with the exception of the “Drop-down” fields listed below.)

Header Information – Self-Explainable

Part A – Contractor or Agency Involved

Contractor/Agency Information – (Select from

Drop-down list)

Part B – Facility Damaged

Enter dates for Damage Occurred and Damage Repaired – (Select date and time from

Drop-down calendar.) You will need to input appropriate time.

Duration of Outage – Calculates time difference between Damage Occurred and

Damage Repaired. (Example: 2 days, 3 hrs, 35 mins.)

Type of Facility Damaged – (Select from Drop-down list) -

Type of Facility Material Damaged – (Select from Drop-

down list) -

1

Location of damaged Facility –

(Select from Drop-down list)

The facility is – (Select from Drop-down list) -

Part C – Locating and Marking

Type of Locate Used – (Select from Drop-down list) -

2

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