Vacaville Unified School District

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Student Accident and Property/Liability Reporting

Effective July 1, 2017, the district's property and liability insurance coverage is provided by Northern California Relief Joint Powers Association. To access current reporting forms, please use the table below and dispose of any older forms you may have for reporting to North Bay Schools Insurance Authority (NBSIA).


Please contact Administrative Services for assistance or to request copies of forms not available on the table below:


Form Name

(Completed by district

employees only)

Description of Report

(Please complete and return as soon as possible after the incident)





Email To



Student Accident/Injury Report


Reporting accidents or injuries involving students

(Please keep signed original and email a copy)




Jenni Yarwood



Vehicle Accident Report 


Reporting accidents involving district owned vehicles




Vicky Rasmussen



Incident Report 


Reporting accidents or injuries involving visitors, etc.

(Do not use to report student or employee injuries)





Vicky Rasmussen



Property Loss Report 


Reporting loss or damage to district owned property or equipment





Vicky Rasmussen