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Inventory Creation

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Inventory Creation & Valuation

Adjuster / Examiner Contact

Name: *

Carrier Name: *

Phone: *

Email: *

Address: *

City: *

State: *

Zip: *

Insured Names and Contact Info (contains some required fields)

Name: *

Address: *

City: *

State: *

Zip: *

Point Person (if commercial):

Primary Phone:

Cell Phone:

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Claim Information (contains some required fields)

Date of Loss:

Cause of Loss: *

Total Square Footage:

Claim #: *

Deductible:

Policy Type:

( Fire loss only) Has the Cause and Origin been completed?:

Total Contents Loss:

Access Restrictions:

If Yes, Describe in Additional Comments Section below

Estimated Amt of Damaged Non-Restorable Contents:

Any collectables or collections:

If Yes, Describe in Additional Comments Section below

Coverage C or BPP Limit:

Policy Sublimits Applicable:

If Yes, Describe in Additional Comments Section below

Apply Depreciation:

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File Attachment (4):

Known Vendors

Restoration Contractor Name:

Restoration Contractor Phone:

Restoration Contractor Email:

Independent Adjuster Name:

Independent Adjuster Phone:

Independent Adjuster Email:

Public Adjuster Name:

Public Adjuster Phone:

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Additional Comments:

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