Chapter 1 - FORM 1-24 : NOTICE OF POTENTIAL CLAIMS TO PUBLIC ENTITIES

• Jurisdiction: Colorado

Form 1-24: Notice of Potential Claims to Public Entities

[date]

CERTIFIED MAIL - RETURN RECEIPT REQUESTED

[names and addresses of entities receiving notification]

RE: NOTICE OF POTENTIAL CLAIMS

To Whom It May Concern:

This notice is being provided to you despite the fact that all the elements of the possible claims or causes of action relating to the damages/injuries/losses described in this notice may not presently be known. This notice is not to be construed, nor is it intended as, an admission that any of the potential claims, causes of action, or acts or omissions described in this notice are subject to Colorado's Governmental Immunity Act or any other notice requirement.

CLAIMANTS' NAMES AND ADDRESSES

The claimants are: [list names and addresses of claimants]. These claimants give notice as to the claims and damages/injuries/losses described below.

CLAIMANTS' ATTORNEYS

[Name of attorney] of [firm name, address, and telephone number] represents the claimants.

NAME AND ADDRESS OF ANY PUBLIC ENTITY AND EMPLOYEE INVOLVED

The following entities and/or employees may be involved in the subject matter of this notice: [list names and addresses of public entities and/or employees involved].

The specific names of the above-referenced employees, agents, and representatives for these entities is undetermined at this time (other than [name], as set forth above) but these persons include, without imitation, those persons with decision-making and enforcement authority regarding the acts and omissions that are the subject of this notice, both in their individual and official capacities.

STATEMENT OF THE FACTUAL BASIS OF THE POTENTIAL CLAIMS

Claims and causes of action may exist against the above-described entities and persons alleging that the acts and omissions of these entities and persons might have contributed to or caused [brief description of claimed damages or injuries]. To the extent that persons, like Claimants or other persons, assert such claims or causes of action, and are able to satisfy their burden of proof regarding the claims or causes of action, then the above listed entities and persons may be wholly or partially at fault for [brief description of claimed damages or injuries] and any resulting injuries, damages, and losses to Claimants. A summary description of these claims and causes of action, and the facts underlying these claims and causes of action, are set forth below:

a. [Insert details of claims, including: date; time; place; act, omission, or

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