If you have knowledge or have received information about a potential claim, please complete the following report as soon as possible. It is very important that the incident is reported timely with whatever information you have so that a claim file can be created, an investigation can be completed, and our insurance representatives can be notified.
Please include claimant's insurance information, how the accident could have been prevented, or any additional information not provided in the description of the incident.
By typing in your name here, you are signing this document.
**Please call Fleet Services at 303-438-6336 or email Public Works at email@example.com if a City/County vehicle is damaged and needs repair.**
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