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Claim Forms

Claim forms are available by:

  1. Calling the City Clerk's office at (650) 802-4222 and asking for a form.
  2. Picking up a form at the City Clerk's office at City Hall located at 600 Elm St., San Carlos (Clerk's Office opens at 9 a.m.).
  3. Downloading the claim form.

Please fill out the claim form completely and sign. Missing information may delay the processing of your claim.

Submit the completed form, along with any accompanying documentation, by mail or in person to: 

City Clerk
City of San Carlos
600 Elm St.
San Carlos, CA 94070

City Hall is open Monday through Friday
8 a.m. to 5 p.m. (the Clerk's office opens at 9 and is closed for lunch)
Closed on holidays


All claims received are forwarded to Sedgwick, our third party administrator. Sedgwick investigates all claims and makes recommendations. The Sedgwick claim examiner will contact you, as the claimant, to discuss the claim and determine damages. The claim examiner then notifies us as to whether the claim should be accepted or denied.

Note: In accordance with California Government Code, claims resulting from damage to personal property, personal injury or death must be submitted within six months of the loss, injury or accident. Claims concerning real property must be submitted within 12 months of the loss.

All claims are public record.