FLORIDA TRAFFIC CRASH REPORT LONG FORM X
SHORT FORM
Crash Date 4/9/2014
Time of Crash 3:05 PM
HIGHWAY SAFETY & MOTOR VEHICLES TRAFFIC CRASH RECORDS NEIL KIRKMAN BUILDING, TALLAHASSEE, FL 32399-0537
UPDATE
Date of Report 4/9/2014
Reporting Agency FLORIDA HIGHWAY PATROL
Reporting Agency Case Number HSMV Crash Report Number FHPD14OFF030470 83773522-01
CRASH IDENTIFIERS County Code City Code 7 54 On Scene Date/Time 4/9/2014 3:15 PM
County of Crash ORANGE Cleared Scene Date/Time 4/9/2014 11:28 PM
Place or City of Crash Within City Limits Reported Date/Time WINTER PARK NO 4/9/2014 3:07 PM Investigation Completed Reason (if Investigation Not Complete) NO PENDING THI
Dispatched Date/Time 4/9/2014 3:11 PM Notified By LAW ENFORCEMENT AGENCY
ROADWAY INFORMATION Crash Occurred on Street, Road, Highway 4035 SR-551 (GOLDENROD ROAD) At Feet Or Miles Direction 0.25 N Road System Identifier STATE
At Street Address # From Intersection With Street, Road, Highway UNIVERSITY BLVD Type of Shoulder CURB
CRASH INFORMATION
Pictures Taken Weather Condition CLEAR
Light Condition DAYLIGHT
First Harmful Event Type COLLISION WITH PERSON, MOTOR VEHICLE, OR NON-FIXED OBJECT Contributing Circumstances: Road NONE Contributing Circumstances: Environment NONE Work Zone Related NO
Crash in Work Zone
VEHICLE
And
Longitude W 81 17.1879 Or From Milepost Number
Type of Intersection NOT AT INTERSECTION
Roadway Surface Condition DRY
First Harmful Event Detail MOTOR VEHICLE IN TRANSPORT
At Latitude N 28 35.9023
School Bus Related NO
First Harmful Event Location ON ROADWAY
Manner of Collision FRONT TO REAR Within Interchange NO
First Harmful Event's Relation to Junction DRIVEWAY/ALLEY ACCESS RELATED
Contributing Circumstances: Road
Contributing Circumstances: Road
Contributing Circumstances: Environment
Contributing Circumstances: Environment
Type of Work Zone
Workers in Work Zone
Law Enforcement in Work Zone
Commercial Motor Vehicle Vehicle Motor Vehicle Type Hit & Run (by this vehicle) License Number State Reg. Expires Permanent Reg. VIN V01 MOTOR VEHICLE IN TRANSPORT YES 548INA FL 8/29/2014 NO 1D4HD48D55F508333 Year Make Model Style Color Extent of Damage Est. Damage Towed Due to Damage Vehicle Removed By Rotation 2005 DODG DURANGO 4D SIL FUNCTIONAL 800 NO Insurance Company Insurance Policy Number ALLSTATE INS. 0710755351020 State Zip Code Phone Number(s) Name of Vehicle Owner Current Address City Business PO BOX 592 GOLDENROD FL 32733-0000 EVELYN RIVERA CORCHADO License Number State Reg. Expires Permanent Reg. VIN Year Make Length Axles Trailer NO One State Reg. Expires Permanent Reg. VIN Year Make Length Axles Trailer License Number NO Two Vehicle Direction On Street, Road, Highway At Est. Speed Posted Speed Total Lanes NORTH GOLDENROD ROAD NB 40 45 4 Traveling CMV Configuration Cargo Body Type Area of Initial Impact Most Damaged Area
Comm GVWR/GCWR
Trailer Type (Trailer One)
;
Trailer Type (Trailer Two)
Haz. Mat. Release Haz Mat Placard
Haz. Mat. Number
Motor Carrier Name
Vehicle Maneuver Action STRAIGHT AHEAD
Vehicle Body Type (SPORT) UTILITY VEHICLE Trafficway TWO-WAY, DIVIDED, POSITIVE MEDIAN BARRIER
City
Vehicle Defects (one) NONE Roadway Grade LEVEL
Traffic Control Device for this Vehicle First (1) Sequence of Events NO CONTROLS COLLISION NON-FIXED OBJECT
Address Other
Comm/Non-Commercial
Haz. Mat. Class US DOT Number
Motor Carrier Address
Undercarriage
State
Vehicle Defects (two)
Roadway Alignment STRAIGHT
Second (2) Sequence of Events
Most Harmful Event COLLISION NON-FIXED OBJECT Third (3) Sequence of Events
Overturn Windshield Trailer Zip Code
; Phone Number
Emergency Vehicle Use Special Function of MV NO NO SPECIAL FUNCTION Most Harmful Event Detail MOTOR VEHICLE IN TRANSPORT Fourth (4) Sequence of Events
MOTOR VEHICLE IN TRANSPORT
VEHICLE
Commercial Motor Vehicle Vehicle Motor Vehicle Type Hit & Run (by this vehicle) License Number State Reg. Expires Permanent Reg. VIN V02 MOTOR VEHICLE IN TRANSPORT NO 0RLCRIB FL 6/24/2015 NO 4T1FA38P36U082474 Year Make Model Style Color Extent of Damage Est. Damage Towed Due to Damage Vehicle Removed By 2006 TOYOT SOLARA CV BLK FUNCTIONAL 4,000 YES A AND A TOWING Insurance Company Insurance Policy Number GEICO INS. 4180705933 Name of Vehicle Owner Current Address City State Zip Code Phone Number(s) Business KIMBERLY BAILEY CAMPBELL 7707 COUNTRY PL WINTER PARK FL 32792-9316 License Number State Reg. Expires Permanent Reg. VIN Year Make Trailer NO One State Reg. Expires Permanent Reg. VIN Year Make Trailer License Number NO Two Vehicle Direction On Street, Road, Highway At Est. Speed Posted Speed NORTH GOLDENROD ROAD NB 30 45 Traveling
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OFFICIAL COPY
Rotation ROTATION
Length Axles Length Axles Total Lanes 4