Contact Information Contact Information City Clerk's Office 952-563-8728 Email staff Title City of Bloomington Claim Form Sections You must be logged in to view this page. City of Bloomington Claim Form You must have JavaScript enabled to use this form. Current Overview Claimant's info Incident/accident info Documents Signature and submission Complete Instructions Per MN Statute 466.05, the claim must be filed with the City Clerk office within 180 days of the occurrence. The claim must be based on the fault or liability of the City or its employees. The City may deny any claim where the City is not at fault. Please complete this form in its entirety by typingyour answer to each question in the space provided. If additional space is needed, please attach additional documents. Attach copies of bills, estimates, pictures, or other documents outlining the basis for the claim to this form. Investigation Once received by the City Clerk, a copy of this form will be sent to Risk & Litigation Management for processing. You will generally receive an acknowledgment of your claim within 14 days. You may request additional information at that time. Claims investigators will research your claim and recommend payment or denial. If you don’t hear from an investigator within 14 days of your claim submission, or you have questions regarding the progress of your claim, call the City’s Risk and Litigation Manager at 952-563-4932.
