File A Claim

Instructions
Lake Arrowhead Community Services District is committed to providing its customers with a safe and reliable supply of water as well as continual sewer services. We strive to maintain our infrastructure and facilities in top condition to ensure a steady supply of water to our customers’ homes and businesses. Additionally, we conduct constant maintenance and repair of our sewer system to reduce the risk of blockages, overflows, and backflows. We do realize that sometimes a leak or a blockage will occur that may potentially cause damage to a homeowner’s property or other conditions may exist that could potentially cause damage.

Determining if a Claim Exists
To determine if the damage is the District’s responsibility and whether or not a damage claim is warranted, please review the District Rules and Regulations. After carefully reading this information and if it is determined that a claim is warranted, a claim form must be submitted to the District in order to begin the investigation process.

Submitting a Claim
Complete the claims-form below or print to complete. Once the claim form is completed, make sure to print a copy for your records. Sending this email does not guarantee receipt of the claim. The claimant is responsible for following up with Human Resources by calling 909-336-7112 or email HumanResources@lakearrowheadcsd.com.

Alternative Delivery Methods:
The information can also be faxed or mailed.
Fax: 909.336.7178
Mailed: Human Resources, PO Box 700, Lake Arrowhead, CA 92352

Investigation Process
The Human Resources department will investigate all claims made against the District as we have a responsibility to protect you as a customer from frivolous claims that eventually increase the cost of services provided. We will contact you if additional information is required to complete the investigation process.

Information Needed To File a Claim:
  • Name of the person filing the claim, address, phone number, and email address.
  • Witness(es) name, address, and phone number.
  • List the date, time and place, and circumstances of the incident/claim.
  • Provide a general description of the incident/claim, injury, damage, or loss as it may be known at the time of the submission of the claim.
  • Provide the name(s) of public employees causing the injury or damage if known.
  • Provide the amount of the claim if the total is less than $10,000.00. If the amount of the claim exceeds $10,000, no dollar amount needs to be stated in the claim.
Don’t forget to:
  • Submit all receipt(s) for the amount being claimed.
  • Submit photographs, if available regarding this incident/claim.
  • Print a copy of the claim form for your records.01
 
CLAIM FOR DAMAGES FORM
Claim Pursuant to Government Code § 910 and 910.4 et seq.