Bonner County Property Damage Report Form
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1Bonner County Property Damage Report Form
Phone Number & Extension:
Title And Name:
Department:
Address:
DID THE LOSS OCCUR AT THE LOCATION ADDRESS? (IF “NO," ADDRESS WHERE LOSS
OCCURRED)
YES
NO
FULL DESCRIPTION OF LOSS (INCLUDE SPECIFICS OF WHERE IT OCCURRED. SUCH AS A WAREHOUSE, STOCKROOM.
DEPARTMENT):
DID THE LOSS INVOLVE: BUILDING (REAL PROPERTY) DAMAGE? IF YES:
DESCRIPTION OF DAMAGE TO BUILDING:
IS ANY INTERIOR SECTION OF THE BUILDING NOW EXPOSED TO THE OUTDOORS AND
UNPROTECTED?
CAN THE BUILDING BE OCCUPIED?
DO YOU HAVE A WRITTEN ESTIMATE OR REPAIR BILL FOR BUILDING? IF YES, AMOUNT
CONTENTS (PERSONAL PROPERTY) DAMAGE? IF YES.
DESCRIPTION OF DAMAGE TO CONTENTS
DO YOU HAVE A WRITTEN ESTIMATE OR REPAIR BILL FOR BUILDING? IF YES. AMOUNT
BUSINESS INTERRUPTION?
WITNESSES (NAMES. ADDRESSES. AND PHONE NUMBERS)
IF IVESTIGATED, AUTHORITIES (NAME. REPORT/CASE NUMBER. COUNTY, ANY
VIOLATIONS/CITATIONS)
Submit form to Risk Management
Office
Created 11/2015
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Parent category: Legal