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Pack Out Estimate Request
Company name
*
Address
*
Contact Name
*
Phone
*
CLAIM INFO
Insured 's Name(s)
*
Multi-line address
Country/Region
Address
City
Zip / Postal code
Email
Phone
Is this a program/ TPA job?
*
Yes
No
Insurance Carrier
*
Claim Number
Multi choice
*
Fire
Water
Flood
Tornado
Hurricane
Mold
Wildfire
Vandalism
Other
Date of Loss
*
Month
Day
Year
PACKOUT
Number of Techs
Days on Site
STORAGE
Storage: Number of months
Storage
On-site containers
Qty. of on-site containers
Size on-site containers
Off-site climate controlled
Off-site climate-controlled
Qty. of Off-Site Climate Controlled
Square Feet
Vaults
Vaults
Qty. of Vaults
TOTAL LOSS
DUMPSTERS
Qty.
TOTAL LOSS
Will you provide a total loss listing?
Single choice
Yes
Single choice
No
ON-SITE TEXTILES COLLECTION
On-site textile Collection
In-house
On-site textile Collection
Vendor
MOVING TRUCK
Number of Days
PACK BACK
Pack Back
N/A
Drop & Run
Full Pack Back
Will you rehang window coverings?
Yes
No
Will you setup bed(s) with sheets and bedding?
Yes
No
Subcontractors or Specalists Involved?
Yes
No
Include invoices from outside service(s)?
Tax % to Charge
Submit links to: Matterport, DocuSketch, Company Cam, Contents Track, Encirlce, Etc.
Attach Vendor Receipts if Applicable
Upload File
NOTES: Please list any challenges of the project to be included in opening statement
Submit
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