Vehicle Accident Report for Business Center North - Risk Management


  • Report all accidents immediately (within two hours) to your supervisor and Risk Management 775-784-4394, whether or not there is damage or injury.
  • If necessary, contact UNR Police Services 775-745-6195 or local police 911.
  • Complete as much information as possible at the scene
  • Cooperate with investigating officers and NSHE adjusters
  • Obtain insurance information from other parties
  • Submit this form to Risk Management within 48 hours
  • Claims reported more than 90 days after the incident may be denied

OUR INFORMATION

Driver's Name

*Please email Defensive Driving Certificate to BCNRisk@unr.edu.

THEIR INFORMATION

Self-insurance card provided to driver/owner?
Owner's Name
Address
Driver's Address
Citations issued?

WITNESSES

Name
Address
Name
Address

PERSONS INJURED

*If injured person is an NSHE employee, complete a Worker's Compensation Claim Form.

Name
Address
Name
Address

After submitting this form, please email three estimates prior to repair to BCNRisk@unr.edu. After review, our office will contact you with more information.

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