Claim For Damages

To file a Claim for Damages against the City of Ridgefield, complete the City’s Claim for Damages form and submit it to Ridgefield Risk Management as follows. Claims may be made for bodily injury or property damage occurring on City of Ridgefield property or as a result of Ridgefield actions/inaction.

State law provides specific requirements for completing a claim form:

  1. A claim form signed by one of the following:
    • Claimant or parent of a minor claimant; or
    • Person holding a written power of attorney for the Claimant; or
    • Attorney-in-fact for the Claimant; or
    • Attorney admitted to practice in Washington State on the Claimant's behalf; or
    • A court-approved guardian or guardian ad litem on behalf of the Claimant
  2. It is strongly encouraged to notarize the form, but not required.
  1. Instructions for Completing the Claim Form
  2. What happens after you file your claim

Download the claim form and type or print the answers clearly in ink.

  1. Provide all requested information. Give specific details about:
    • what happened, 
    • the location where it happened, 
    • date and time, 
    • any witnesses having knowledge of the incident including their names and contact information, 
    • If you are claiming damages to an automobile, provide information regarding the driver and owner of the vehicle, and your damage or loss. 

If requested information cannot be supplied in the space provided, you can type or print on a separate sheet.

  1. If the incident that caused the damages occurred over a period of time, please provide the beginning time and ending time. 
  2. Provide the dollar amount for your damages that should represent your opinion of total compensation. 
  3. Provide any available documents or evidence supporting your claim such as damage estimates, receipts, bills, or photographs.
  4. If the incident was reported to law enforcement, please provide a copy of the report or the contact information for the report. 
  5. If a claim has been submitted to your insurance carrier please provide your insurer’s information, including company name, telephone number and claim number.  

Be sure to sign and date your completed claim form.

Submit your completed claim form and supporting documents via email to: Lee.Knottnerus@ridgefieldwa.us 

OR

Hand deliver or mail your completed claim form and supporting documents to:

City of Ridgefield
c/o Lee Knottnerus, Deputy City Manager
230 Pioneer Street
P.O. Box 608
Ridgefield, WA 98642

Business Hours: Monday - Friday 7:30 AM to 4:30 PM

Note: Records you submit are subject to public disclosure laws.