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HomeMy WebLinkAboutFC-18 - Property Loss Notice      FC-18   PROPERTY LOSS NOTICE       DEDUCTIBLE INFORMATION   DEPARTMENT       DIVISION       FUND:                 CONTACT PHONE:       CELL PHONE:  ORG:                  DATE OF LOSS               CAUSE OF LOSS         (Check one)  Theft/Burglary  Vandalism  Fire  Other  (see reverse)             DETAILS OF LOSS                            DESCRIPTION OF PROPERTY                            ASSET #       MAKE       MODEL       YEAR      BLDG #                   LOCATION OF LOSS       POLICE REPORT #                   PREVIOUSLY REPORTED YES  NO  WORK ORDER #       EPO #                   BY/TITLE                       PRINT NAME:       SIGNATURE  DATE              ATTACH ADDITIONAL SUPPORTING DOCUMENTATION AS REQUIRED                 TO: General Services Department – Division       Date           2101 G Street         Fresno, CA 93706   Phone #                   SCOPE OF WORK                                                 Work Order #        EPO #       By/Title                                TO: Risk Management Division   Date           2600 Fresno Street, Rm. 1070         Fresno, CA 93721   Phone #                   FINAL REVIEW             Authorized Yes  No   Rm #                  Supplier #       Phone #       PO #       Invoice