Notice: Information contained in this document may be disclosed to Charleston Water System (CWS) officials, associates, and General Counsel and their staff involved in the processing of your claim.
Please provide a description of the claim you are making against Charleston Water System. The
acceptance of this claim by Charleston Water System does not constitute an admission of legal liability on the part of CWS or any of its departments. Failure to provide adequate information may result in your claim being returned or denied.
Select all that apply.
Please describe the injury or damages. If medical attention was provided, provide the names and addresses of treating medical providers and medical reports and billings.
If yes, please provide a copy of the incident report in the next section.
Please be specific, providing any intersections or notable landmarks.
Please provide the names, addresses, and telephone numbers of all persons involved in or witness to this incident.
Please provide copies of any paid receipts or estimates in the next section.
Below are instructions for how to submit your supporting documents.
You will have the option to print this form and receive an email copy with this information.
Attn: Terry Williams, Tort Claims
Charleston Water System
Attn: Tort Claims
PO Box B Charleston, SC 29403
103 St. Philip Street
Charleston, SC 29403
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