Quick Tips Sample Water Damage Paperwork - Jon-Don

Water Damage Paperwork Copyright 2004 Jon-Don (800)-556-6366 400 Medinah Road Roselle, IL 60172 Water Damage / Paperwork - 1a Water Damage Worksheet (first section office use) Name: _____ Date: _____ Day of Week: _____ Job Address: _____ Time of Call: _____ Contact:_____ E-mail: _____ Home Phone: _____ Contact #: _____ Billing Address: _____ Husb. work: _____ Husb. Cell: _____ T? _____ Wife work: _____ Wife Cell: _____ T? Insurance Co: _____ Agent: _____ Phone: _____ Insurance Adjuster: _____ Phone: _____ Cell: _____ Floor Underneath: Concrete Particle Board Red-X Plywood Hardwood T&G Other Is this a 5th Generation carpet? Yes No Clean Sewer How long wet?_____ Type of Carpet: glued down stretched in Power: On Off Heat: On Off What happened?

on this letter, we will send you a statement which will include interest charges. To avoid these late charges, we suggest that you immediately contact your insurance agent or adjustor to see if additional paperwork is required from you to process your claim. Our Company has no influence with your insurance company - you have a great deal of ...

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