Business Damage Assessment Form

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Use this form to help Grays Harbor County register damages that were incurred to businesses or commercial property due to the recent flooding in the county.

Fill this form out one time for each location where damage occurred. Do not combine locations into one form.

To report damage to a primary residence, click here.

To report damage to a secondary or rental house, click here.

All questions must be answered in order to process.

Business Information

Name of Business*

Business Owner Name*

Address where Damage Occured*

Are you a tenant or owner of this location?*

Financial Impact

Estimated Pre-Disaster Value of Business*

Estimated Structure Loss in Dollars*

Estimated Loss of Furnishings / Inventory, ect.*

Primary Cause of Damage*

If you have insurance, what is your deductible?

If you closed, how many days were you closed or how many days do you anticipate until you re-open?*

Do you have Business Continuity Insurance?*

Category of Damage*

Description of Damages*

Contact Information

Contact Name*

Contact Phone Number*

Contact Email Address*

If you also have additional damage to report for an additional business location, a rental property that you own, your personal residence, or a vacation home, please return to the main page and submit an additional form.

For assistance with needs, call Grays Harbor County Emergency Management at (360) 249-3911