What does the Liability Claim Form ask for?

It asks for claimant contact information, the amount claimed, incident details, a description of the claimed damages, and the names of public employees involved, if known.

What should I attach to the form?

The form asks claimants to attach copies of bills or estimates. It also asks claimants with amounts over $10,000 to indicate where jurisdiction rests.

Do I need a notary for the Liability Claim Form?

No. The claimant signs and dates this form; it identifies no sworn or notarized attachment.

How do I submit the Liability Claim Form?

Return it to the Administrative Services Department at 501 Main Street, Half Moon Bay, CA 94019. Attach copies of bills or estimates.

Half Moon Bay, CA · San Mateo County

No notary required

Liability Claim Form

This form lets a person submit a claim to the City of Half Moon Bay for damages they believe resulted from an incident involving the City.

What this form is

Use this form to present a liability claim to the City of Half Moon Bay for damages connected to an incident. It asks for claimant and notice-contact details, the amount claimed, incident date, time and location, an incident and liability explanation, damages, and any public employees involved. Attach copies of bills or estimates, and indicate the civil case jurisdiction if the amount exceeds $10,000.

Who needs it

A person claiming damages from an incident they believe makes the City of Half Moon Bay liable can complete and submit this form.

How to submit it

Return the form to the Administrative Services Department, 501 Main Street, Half Moon Bay, CA 94019. Attach copies of bills or estimates.

About notarization

This document is signed and dated without a notary; the form says the claimant signs, and it identifies no sworn or notarized attachment.

How to submit this form

1
Download The Form
Download the City of Half Moon Bay Liability Claim Form.
2
Complete The Form
Enter claimant and notice-contact details, the amount claimed, incident information, damages, and any public employees involved.
3
Gather Attachments
Attach copies of bills or estimates. If the amount exceeds $10,000, indicate where jurisdiction rests.
4
Submit To The City
Return the form to the Administrative Services Department, 501 Main Street, Half Moon Bay, CA 94019.

Frequently asked questions

What does the Liability Claim Form ask for?: It asks for claimant contact information, the amount claimed, incident details, a description of the claimed damages, and the names of public employees involved, if known.
What should I attach to the form?: The form asks claimants to attach copies of bills or estimates. It also asks claimants with amounts over $10,000 to indicate where jurisdiction rests.
Do I need a notary for the Liability Claim Form?: No. The claimant signs and dates this form; it identifies no sworn or notarized attachment.
How do I submit the Liability Claim Form?: Return it to the Administrative Services Department at 501 Main Street, Half Moon Bay, CA 94019. Attach copies of bills or estimates.

Need something notarized?

This Liability Claim Form doesn’t need a notary — but if you have another Half Moon Bay form that does, a commissioned online notary can help.