028-1996 DM
CITY HALL t700 CONVENTION CENTER DRIVE MIAMI BEACH FLORIDA 33139
CITY OF MIAMI BEACH
OFFICE OF THE CITY MANAGER TELEPHONE: (305) 673-7010
FAX: (305) 673-7782
DEPARTMENT MEMORANDUM NO. 28-1996
TO:
All Department Directors
DATE: July 16,1996
Jose Garcia-pedros!!
City Manager
SUBJECT: City Property/Notifi ti n of Damage
Risk Management operty Damage Claim Form
FROM:
~
When reporting a theft or damage involving City property, please follow the steps outlined
in the City of Miami Beach Administrative Policy Manual. Procedure, No. 8.10.00,
"Reporting Accidental Property Damage or Loss". In order for your department to get
reimbursed from the City's self-insurance fund, the attached Risk Management Property
Damage Claim Form, as well as a Purchase Requisition Form with an open budget code,
must be completed simultaneously and submitted to the Office of Risk Management. If the
reimbursement is approved, this will allow for more expeditious processing of your request.
If you have any questions, or if you need additional copies of the Property Damage Claim
Form, please contact Risk Management, 673-7014.
/J
JGP:RWB:lsg
Attachment
a:\COMM.MEM01~6\BENDR.EX.APT
f:\CMGR.$ALLIDEPTMEMO.96\PRP-DMG.FRM
cc:
Mayor and City Commissioners
Sergio Rodriguez, Deputy City Manager
Mayra Diaz-Buttacavoli, Assistant City Manager
Joseph Pinon, Assistant City Manager
Harry Mavrogenes, Assistant City Manager
Peter Liu, Executive Assistant to the City Manager
Jack Lubin, Executive Assistant to the City Manager/Interim Parking Director
Richard Bender, Executive Assistant to the City Manager/Labor Relations
Clifton Leonard, Claims Coordinator/Office of Risk Management
Ron Caplan, Safety Officer .
-
.
RISK MANAGEMENT PROPERTY DAMAGE CLAIM FORM
---
Today's Date:
Department:
Person Responsible for Property:
Location of Loss:
Date of Loss:
Cause of Loss ( Fire, Theft, or Vandalism, Etc.):
Description:
(continue on a separate sheet if necessary)
Statement of How Loss Occurred:
,--- PolicelFire Department Case Number: Serial Number:
Replacement Cost: Person Reporting Claim:
Supervisor's Signature:
I TO BE COMPLETED BY RISK MANAGEMENT
o Approved
o Denied
,---
Explanation:
Please attach and send purchase requisition form with budget code blank.
Payment Authorized by:
Signature required
I