Get General Liability Claim Form #sf 210 - Seattle

Filing a general liability claim can be a straightforward process when you understand the necessary steps. This guide will provide you with a clear and comprehensive overview of how to fill out the General Liability Claim Form #SF 210 for the city of Seattle effectively and accurately.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to access the General Liability Claim Form #SF 210 and open it.
2. Begin by entering the claimant's name, including last name, first name, and middle name, along with their date of birth using the specified format (mm/dd/yyyy).
3. If applicable, input the inmate DOC number. If not, you can skip this field.
4. Provide the current residential address, ensuring that all entries are accurate and complete.
5. If you have a different mailing address, enter that next; otherwise, continue to the next field.
6. Fill in the residential address at the time of the incident, if different from the current address.
7. Enter the claimant's daytime telephone number, specifying whether it is a home, business, or cell phone.
8. Provide the claimant’s email address for further communication regarding the claim.
9. Record the date of the incident and the time, ensuring to select either a.m. or p.m. as applicable.
10. If the incident spanned a period, indicate the dates of the first and last occurrences, including the respective times.
11. Specify the location of the incident, including the state, county, and city where it happened.
12. Identify the state agency or department alleged to be responsible for the damage or injury.
13. List the names, addresses, and telephone numbers of all individuals involved in or witnesses to the incident.
14. Provide details of state employees who have knowledge about the incident.
15. Include any other individuals who might have knowledge regarding liability issues or the claimant’s damages.
16. Describe the cause of the injury or damages in detail, including the nature and extent of property loss or injuries.
17. State whether the incident was reported to law enforcement or safety personnel, providing details about when and to whom.
18. List the names, addresses, and telephone numbers of treating medical providers, and ensure to attach copies of all relevant medical reports.
19. Attach any documents that support the allegations made in the claim.
20. Finally, claim damages by specifying the amount desired, and ensure the form is signed appropriately. This may be by the claimant, a representative, or an attorney.
21. After completing the form, review all entries for accuracy, then save changes, download, print, or share the form as needed according to your filing method.

Start filling out your General Liability Claim Form online today to ensure your claim is processed smoothly.