Organization Name *

Contact Name *

Contact Title *

Contact Phone *

Best Phone Number

Mobile / Cellular Phone or Landline *

Cell/Mobile

Work Landline

Mobile / Cellular Phone or Landline

Contact Email *

Date of Loss *

When did the loss occur?

Address

Street Address *

Where did the loss occur?

City

State

Country

Postal code

What's going on with the claim? *

Full detailed description please

Do you have your FULL Policy?

Certified Copy of Your Policy - is the FULL policy certified accurate

Declarations page (Dec Page) - It's the summary

Insuring Agreement - It's the main document with the details

All Endorsements - Like addendums they change the policy

Dec Page = summary-Insuring agreement=main document-Endorsements=addendums to the policy.

Upload Certified Copy of your Policy - Certified by your Carrier to be Accurate

Certified Policy

A certified copy of your policy includes the Dec Page, the Insuring Agreement, and all Endorsements

Upload Dec Pages

Dec pages aka Declarations pages are the summary

Upload Insuring Agreement

Insuring Agreement

The Deatails of the policy, what triggers coverage, how it works, exclusions, responsibilities, etc..

All Endorsements

Provide a link to the documents or send the claim file via WeTransfer

If WeTransfer: Subject line "Your-Co_Address-state

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