USE OF THIS REPORTING FUNCTION BY MEMBERS OF THE GENERAL PUBLIC IS NOT AUTHORIZED. ATTEMPTED SUBMISSION OF A GOVERNMENT CLAIM THROUGH THIS WEBSITE DOES NOT CONSTITUTE VALID PRESENTATION OF A CLAIM AS REQUIRED BY GOVERNMENT CODE SECTION 910, DO NOT ATTEMPT TO PRESENT A CLAIM FOR WHICH PRESENTATION IS REQUIRED IN ACCORDANCE WITH GOVERNMENT CODE SECTION 910 AS IT WILL NOT BE RECEIVED FOR ACCEPTED, AND THE ATTEMPTED PRESENTATION IS INVALID.
Claims reporting requirements and loss forms can be found on this page. Please review all information and follow the procedures as described. Information contained on this page is in addition to following your city's procedures for reporting and responding to an incident. You should alert local emergency authorities as appropriate.
Allied Call Connect will handle each report of injury as it occurs by a Registered Nurse. The nurse will triage the injury, provide self-care instructions as appropriate, or direct the employee to the appropriate clinic designated by each City. Please also be advised that if the injury is life-threatening, the employee will be instructed to go directly to the emergency room. The report of injury can be completed by a supervisor or employee after the emergency has been addressed.
Electronic Payment Information – FAQ – Login Required
California Auto Liability Coverage Identification Card – Login Required
Vehicle Accident Report Form – Login Required
Auto Physical Damage Coverage Addition Form (right-click to open link in a new tab)
Low Value Vehicle Coverage Addition Form (right-click to open link in a new tab)
In an effort to help reduce/mitigate sidewalk liability claims, the CSJVRMA Executive Committee has approved a sidewalk program for the 2020/21 program year. Through this program, member cities can request reimbursement of up to $1,000 for expenditures related to sidewalk liability mitigation including:
Reimbursement requests should be submitted to Tom Kline, Risk Control Manager, utilizing the form and including proof of the expenditure. The form can be emailed to Tom at firstname.lastname@example.org. Expenses for the 2020/21 program year must be expended between July 1, 2020, – June 30, 2021, and the reimbursement request must be received by
July 31, 2021.