Claims

Filing a Claim

If you have been injured or your property has been damaged and you believe Skamania PUD may have a responsibility to you, you must file a Claim for Damages Form in order for the PUD to determine its level of responsibility to you, the claimant.

A Claim for Damages form can be completed by using the form below, by phone, or in person at our office.

Submitting a Claim for Damages Form does not guarantee payment by Skamania PUD or its insurance administrator. A claims adjuster will investigate the incident to determine whether the PUD has any liability according to applicable laws.

Post Office Box 500
Carson, WA 98610
Phone: (509) 427-5126
Toll Free: (800) 922-5329
Fax: (509) 427-8416

Claim for Damages Form

This claim is made by and for:

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Date of incident (MM/DD/YYYY)(Required)

Approximate time of incident(Required)

Describe in detail the circumstances that brought about the injury or damage and describe the injury or the item(s) that were damaged. Please include witnesses, if applicable, to the occurrence, and their contact information.(Required)

The alleged negligence on the part of Skamania PUD, which allegedly makes the District liable for damages, consists of doing or failing to do the following:(Required)

Amount of claim is:(Required)

File

Attach receipts and/or estimates

Drop files here or

Max. file size: 2 GB.

Claimant Electronic Signature (Full Name)(Required)

Name

This field is for validation purposes and should be left unchanged.