SURVEYOR ASSIGNMENT FORM - DAMAGE CLAIMS

Insurance Co.
Examiner Name:
Phone:     Fax:
 Email:
Named Insured:
Phone #:              Email:
Claim #:          Policy #:
Date of Loss:    Policy Period:
Policy Limits:  
Hull:       Deductible:
Motor:       Deductible:
Trailer:       Deductible:
Contents:       Deductible:
Vessel Make / Model:
HIN:
Location of boat:
Repair facility / contact:
Description of Loss:
Handling Instructions:

 

 

 

Please Send Notice Of Loss And Insurance Coverage Sheets If Possible.

No Need To Duplicate Information If Attachments Contain Assignment Information.


ABYC

 

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