2. Please complete one form per concern/request. Should a problem require urgent attention, please call us immediately at (510) 494-4745 during normal work hours (Monday - Friday, 8:00 am - 5:00 pm except holidays). For an after hours emergency, please contact the Police Department at (510) 790-6800.
4. 
   
6. Please check the relevant box and complete the "Comments" and "Location Details" sections so we have as much information as possible to assist you.
8. 
   
10. Thank you!
12. 
    
14. Please provide your contact information so we may respond to you. Your email address is required.
16. Name*
17. Phone Number
    with area code
18. Email*
20. Mailing Address for Bike Map Request
21. 
    
23. PLEASE CHECK ONE BOX ONLY*

    1. Traffic signal light burned out/flashing
    2. Traffic signal not responding
    3. Traffic signal head damaged/turned
    4. Traffic signal pole damaged/knocked down
    5. Pedestrian push button/pedestrian signal
    6. Stop sign request
    7. Crosswalk request
    8. Parking restrictions request
    9. Fremont Bikeways Map request
    10. Railroad Quiet Zones
    11. New traffic signal request
    12. New traffic sign request
    13. Pavement marking request
    14. Other (please fill in Comments section)
25. Location Details (name of intersection, direction of travel, time of day)
26. Comments/Brief Description (or other problem not listed)
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field