Generic worksheet with one column for text detail and 3 columns for numeric calculation.
Used to notify one or more insurance company as to the extent of damage on an inspected property loss. The adjuster "certifies" the loss and recommends payment as stated on the form.
The Adjusters Report/Certification form is similar to form 2110F but includes more detail regarding structural, contents and additional living expense payment recommendations. The adjuster certifies the loss and requests payment with this form.
Form 2300F © 2004 Nationwide Publishing Company, Inc. http://www.claimspages.com PROPERTY LOSS WORKSHEET Claim Number: Insured: Claimant: Adjuster: Preliminary Estimate: $ Final Estimate: $ 1 2 3 4 5 6 7 8 9 ITEM DESCRIPTION QUANTITY UNITS PRICE COST AGE ORG. COST REP.COST DEPREC. A.C.V. LOSS -DAMAGE INSTRUCTIONS-Columns 4-9, unshaded...
Loss Notice - Auto Worksheet - Travelers, 1350F
Loss Notice - Liability Worksheet - Travelers, 3290F
Loss Notice - Property Worksheet - Travelers, 2480F
Loss Notice - Workers‘ Comp Worksheet - Travelers, 5530F
Manufactured (Mobile) Home/Travel Trailer Worksheet (FEMA Form 086-0-17, Oct 2010)
Manufactured (Mobile) Home/Travel Trailer Worksheet - Continued (FEMA Form 086-0-18, Oct 2010)
Worksheet Contents Personal Property (FEMA Form 086-0-6, Oct 2010)
Worksheet-Building (FEMA Form 086-0-7, Oct 2010)
Worksheet-Building-Continued (FEMA Form 086-0-8, Oct 2010)
An ACORD form for calculating the replacement cost of a residential dwelling using the Boeckh square foot method. This form is used by insurance agents to determine how much coverage should be written when an application is submitted, and by insurance claims adjusters after a loss when checking the adequacy of coverage per the coinsurance clause.
An MS Word form setting forth a list of modifications of bodily injury reserves by date showing who authorized each change.
HOJA DE CÁLCULO DE PERDIDA MATERIAL Número de reclamación: Asegurado: Demandante: Ajustador: Monto preliminar estimado: $ Monto final estimado: $ ...
Form 9210F © 2004 Nationwide Publishing Company, Inc. http://www.claimspages.com Wrongful Death Worksheet Full Name Date of Birth Address Life Expectancy Instantaneous Death? Personal Representative’s Name/Address Health Problems Family Doctor(s) Habits Character Issues