|
Your contact information: |
|
Name: |
|
|
Address: |
|
|
City: |
|
|
State: |
|
|
ZIP: |
|
|
Phone: |
|
|
Email: |
|
|
|
|
Your contact information is important to us so that we can fully evaluate
your complaint. Once completed, this form will be considered public
record unless one of a limited number of specific exemptions applies. |
|
|
|
Please complete all questions to the best of your ability. |
|
|
|
WHO are you reporting? |
|
|
|
WHO else is/was involved in this activity? |
|
|
|
WHO else is aware of the activity? (Please give phone
number(s) or other contact information for each individual) |
|
|
|
WHAT specifically did this person or company do that
you think might be against the law, state policy, or against Florida
Department of Transportation procedure? |
|
|
|
WHAT specifically do you believe, specifically, this is a violation of?
|
|
|
|
WHAT is the project number, contract number, bridge
name, highway name, or similar identifier? |
|
|
|
WHAT other agencies (or supervisors) have been notified of this matter? |
|
|
|
WHEN did this misconduct or illegal act take place? If it is not a
one-time event, when did you first notice it and has it stopped yet? |
|
|
|
WHERE did the activity occur?
|
|
|
|
WHY do you believe the person did this? Was there personal gain for that
person as a result of committing this act?
|
|
|
|
HOW did this actually get carried out? How was it possible?
|
|
|
Additional information can be
mailed to:
Florida
Department of Transportation
Office of Inspector General
605 Suwannee Street, MS 44
Tallahassee, Florida 32399-0450 |
