General Liability Loss Notice

General Liability Loss Notice

Use this form if any third party is claiming damages due to alleged negligence on the part of the County from causes other than auto accidents. Form Preview
General Liability Loss Notice
  • GENERAL LIABILITY LOSS NOTICE

  • Basic Loss Information

  • Use this form if any third party is claiming damages due to alleged negligence on the part of the County from causes other than auto accidents.

  • Contact Information

  • Claimant Information

  • Witness Information #1

  •  -
  • Witness Information #2

  •  -
  • Should be Empty: