General liability - property damage claim form - City of Chicago - cityofchicago 2025

1. Click ‘Get Form’ to open the General liability - property damage claim form in the editor.
2. Begin by filling out the Claimant Information section. Enter your name, street address, city/state/zip code, and telephone numbers (home, work, mobile) as required.
3. In the General Claim Information section, provide the date and time of the incident. Describe in detail how the incident occurred and include the street address of the incident location.
4. Next, complete the Insurance Information section. Fill in your insurance company's full name, address, adjuster's name, and contact number. Also include details about the policy holder and policy number.
5. For Witness Information, enter the witness's name, address, and telephone number if applicable.
6. In Additional Information, specify your reason for claiming and any remedies sought. Include any relevant city department information and attach estimates or paid bills as necessary.
7. Finally, verify your information by signing in the Signature Information section. Ensure all required fields are completed before submitting.

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