Claims Against The City Form

Information Regarding Filing a Claim Against the City of South San Francisco

As a service to residents and visitors, the Finance Department performs the intake and routing functions involved in the City’s claims process. Claims are resolved by the City's Risk Manager.

Instructions

An original and one identical copy of the form entitled “Claim Against the City of South San Francisco” together with any attachments is to be filed with the Finance Department. Retain one copy for your records. You may deliver your claim in person to the Finance Department (City Hall, 400 Grand Avenue) or mail it to the following address:

Finance Department - Claims
P.O. Box 711
South San Francisco, CA 94083

Notice: The Finance Department is the only office to which claims may be submitted.

All claims require a wet signature as electronic signatures will not be accepted

Procedures

Claims received by the Finance Department are forwarded to the City Attorney and processed by the Risk Manager Jason Wong. All questions regarding your claim should be directed to Patty Gomez, 650-877-8510.

If recommended for denial by the Risk Manager, the Finance Department will send claimants a letter of notice regarding the action taken and of any further action available to you.

All claims are public record.