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Liability Claim Form
To submit a claim to the City of Champaign, please provide the following information. Any claim submitted has to be investigated. You will be contacted to let you know if your claim has been accepted.
Name
*
First
Last
Address
*
Street Address
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Date of the Incident
*
If you do not know the exact date of the incident, please pick the date closest to the incident.
MM slash DD slash YYYY
Location of Incident
*
Please be as specific as possible, giving information such as eastbound, southbound, lane nearest curb, etc.
Description of Incident
*
Please provide as much information as possible.
Nature of Injury or Property Damage
*
Year, Make, and Model of Vehicle (If a personal vehicle is involved)
Was a City of Champaign vehicle involved?
Yes
No
If yes, what is the vehicle number and/or driver's name?
Have you spoken with or reported this incident to anyone at the City of Champaign?
Yes
No
If yes, what is the person's name, position, and phone number?
*Indicates a required field
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Current Openings
The City of Champaign currently has these exciting job opportunities. Select a position below to learn more and to apply to join our team!
Human Resources Department News
City Holds Police Service Representative Recruitment Meeting
December 15, 2022
HR Offers Interviewing Approaches for the Interviewer Training
October 13, 2022
City of Champaign Celebrates Pride Fest 2022
October 6, 2022