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Use this form to file an insurance claim against the City.

1. Provide a completed form, and include at least two estimates for repairs to damages (or receipts if repairs have been completed) to the Legislative Services Department.

2. The claim will be investigated and you will be notified of the City's decision.

Please also refer to the checklist for making a complaint or claim to the City.

For further information, you can contact the Insurance Coordinator of Legislative Services via e-mail ( or at 780-830-7429. 

Download the Statement of Damages/Injury Form (PDF, 373KB).


By mail:
Legislative Services
PO Bag 4000
Grande Prairie, AB
T8V 6V3

In person:

1st Floor City Hall
10205 – 98 Street, Grande Prairie

Phone: (780) 830-7429
Fax: (780) 539-1056

Last updated: 12/11/2017 9:55:49 AM