Tort Claim

If you believe you have experienced damages due to PUD negligence, your situation may be reimbursable via a tort claim by filling out the form below. However, the vast majority of outages are not due to PUD negligence. Most are unpredictable and unavoidable “Acts of God” such as windstorms, fallen trees, car accidents (downed pole), etc. that are beyond the control of the PUD and therefore are not eligible for claims. We highly recommend you install whole home and individual circuit surge protection to protect your home and personal electronics from damage.

Name of Claimant

First Last

Address

Street Address Address Line 2 City ZIP / Postal Code

Phone

Date of Incident

Time of Incident

Describe in detail what happened and the item(s) that were damaged. Please include time of day incident occured, witnesses, and who at the PUD was notified and when they were notified.

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

Amount of Claim:

You must retain receipts for any items you have purchased pertaining to the claim.

Document Uploads:

Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 128 MB.

Photos of Damages:

Drop files here or

Accepted file types: jpg, jpeg, pdf, png, gif, Max. file size: 128 MB.

Signature

Date

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Phone

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