Property Loss Notice
	Member Section Supervisory Union SU Contact Phone choose one Addison Central Addison Northeast Addison Northwest Addison Rutland Barre Battenkill Valley Blue Mountain Colchester Franklin Central Franklin Northeast Franklin West Lamoille North Montpelier Orange East Orange North Orange Southwest Orange Windsor Orleans Central Orleans Southwest Orleans-Essex North Patricia A. Hannaford Career Center River Valley Technical Center Rutland Central Rutland Northeast Rutland South Rutland Southwest South Burlington Springfield Washington Northeast Washington West Windham Northeast Windsor Central Windsor Southeast Windsor Southwest Winooski () -   SU Contact Person SU Contact Email Loss Section Loss Location (Name of School) Date of loss Loss Location - Address   Contact Person (if different than above) Contact Phone () - Contact Title (principal, facility manager...) Contact email The most likely cause of loss is? (choose one) Water   Fire   Theft   Lightning   Ice/Snow Vandalism   Wind   Electrical Other: Please describe the damage caused by the loss: Was this incident reported to the police or fire dept.? Yes   No If yes, please indicate agency type and location Have you received any estimates or invoices in relation to this incident? Yes   No What is the expected amount of the entire loss? This notice was submitted by: on:
Copyright 2008 � VSBIT   All Rights Reserved