Incident Cost Calculator Your Information Name of company Date of incident (e.g. 28/02/2002) Time of incident (e.g. 14:30) Place of incident Name of person involved Name of person completing form Position of person completing form Description of Incident Dealing with Incident (immediate action) Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed First-Aid treatment   hrs Taking Injured person to hospital/home   hrs Making the area safe   hrs Putting-out fires   hrs Immediate staff downtime (e.g. work activity stopped)   hrs Other   hrs Investigation of Incident Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed Staff time to report and investigate incident   hrs Meetings to discuss incident  hrs Time spent with HSE/local authority inspector  hrs Consultant's fees to assist company in investigation   hrs Other   hrs Getting back to business Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed Assessing/rescheduling work activities   hrs  Recovering work/production (including staff costs)   hrs Cleaning up site and disposal of waste, equipment, products, etc.  Bringing work up to standard (e.g. product reworking time/costs)   hrs Repairing any damage/faults  Hiring or purchasing tools, equipment, plant, services, etc.  Other   hrs Business Costs Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed Salary costs of injured person   dys  Salary costs of replacement workers   dys    Lost work-time (people waiting to resume work, delays, reduced productivity, effect's on other people's productivity, etc.)   dys Overtime costs    dys    Recruitment costs for new staff                 Contract penalties  Cancelled and/or lost orders  Other   dys Action to safeguard future business Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed Reassuring customers  Providing alternative sources of supply for customers Other   hrs  Sanctions and penalties Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed Compensation claim payments  Solicitor's fees and legal expenses Staff time dealing with legal cases   hrs  Fines and costs imposed due to criminal proceedings                 Increase in insurance premiums  Other   hrs Other Please enter as decimal hours: (eg 3hrs 30min = 3.5) Time spent (eg 7.5) Rate in £ (eg 6.50) Cost in £ (eg 9.54) Tick if guessed  hrs   hrs  hrs  hrs Total Time Spent Cost (£) Totals:  dys  hrs