Information
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Prepared by
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Forward via email within twenty-four (24) hours to GM, Controller​, Dir of Rooms, and ​ to Jason Provost
(Jprovost@provostassociates.com)
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Date and Time of Incident
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Claimant Name
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Room Number (if applicable)
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Address
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City
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STATE
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Zip
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Phone--Home/Office or Cell
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Email address
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Type of Situation
- Accident/Injury
- Personal Property Loss
- Hotel Property Damage
- Vehicle Damage
- Hotel Property Loss/Theft
- Other--Specify
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Pictures If Applicable
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Detailed Description of the incident
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Witness (if any)
