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Claim for Damages
In accordance with the Revised Code of Washington 4.96, the Board of Trustees of the Pierce County Library System has appointed an authorized agent to receive claims for damages against the library system. The name and address of the agent has been duly filed and recorded with the Pierce County Auditor’s Office.
The designated agent to receive claims for damages during normal business hours is:
Georgia Lomax, Executive Director
Pierce County Library System
3005 112th St. E.
Tacoma, WA 98446
Phone: 253-548-3300
Business hours: Monday-Friday, 9 a.m. to 5 p.m.
Closed on weekends and official Library holidays.
Claim for Damages form (Tort Form)
The Claim for Damages form is available for download, or call the Executive Assistant at 253-548-3420 to obtain a form by mail.
Claim Submission
Pursuant to Title 4, Chapter 96 of the Revised Code of Washington, all claims for damages against any local government entity shall be presented to and filed with the government entity and the government entity’s designated agent within the applicable period of time limitations. RCW 4.96.020. All claims shall describe the conduct and circumstances, location, which brought about the injury or damage, describe the injury or damage, date, time, location, witnesses if known. In addition, it is necessary to provide adequate independent supportive documentation in support of your claim, for example: repair costs estimates, medical bills, loss wages earning statement, etc.
1. Complete the “Claim for Damages” form.
2. Attach relevant supporting documents or additional evidence.
3. The Claim for Damages form must be signed.
4. Mail or deliver the original, signed form and supporting documents to:Georgia Lomax, Executive Director
3005 112th St. E.
Tacoma, WA 98446Business hours: Monday-Friday, 9 a.m. to 5 p.m.
Closed on weekends and official Library Holidays.5. The designated Claims Agent will acknowledge, in writing, receipt of the Claim within seven (7) calendar days. This acknowledgement does not indicate the Pierce County Library's agreement that your claim should be allowed or is legally sufficient.
6. After filing the claim, please direct any further correspondence or inquiries you have about the claim to Clifford Jo, Finance and Business Director at 253-548-3453. (Office hours, Monday through Friday, 9 a.m. to 5 p.m.)
Make copies of your Claim for Damages form and attachments for your personal records before submitting. Submittal material will not be returned.
Legal Requirements for Presenting a Claim for Damages Form
In order to verify the claim and additional supporting information, the law requires that the Claim for Damages form be signed by one of the following:
1. The Claimant; or
2. A person holding a written power of attorney from the Claimant; or
3. An attorney admitted to practice in Washington state on the Claimant’s behalf; or
4. A court-approved guardian or guardian ad litem on behalf of the Claimant.
Additional information
State law requires an original signature on the Claim form. This means the form cannot be submitted electronically (fax or email).
All documents are subject to Washington State Public Disclosure Statutes and are public records accessible upon request.
Administrative Policy 1.1
Effective October 17, 2001
Revised August 10, 2011
Revised November 20, 2014
