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Contractor Report Form
Questions marked by * are required.
1. Your Local Number: *
2. Name of Contractor (Signage): *
3. Contractor address:
4. Telephone or website address: *
5. Number of Contractors: *
6. Performing specifically what work:
7. Were they wearing work area protection and following state and/or federal laws such as OSHA? Explain:
8. What type of interaction(s) with represented Qwest employees or managers: *
9. Do they use their own tools, equipment and materials or are they supplied by CenturyLink? Explain: *
10. Date and Time of observation(s): *
11. Your personal Email address If you wish the answers to the questions sent to you:)
12. Click here to upload pictures. (Please have file no larger than 8 megs):


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For problems or questions regarding this web contact
Rick Sorensen or Jay Lute
Last updated: January 22, 2014.