File a Claim

Company Name (required)
Contract Number (required)
Claim Contact Name
Claim Contact Phone
Claim Contact Email Address
Date of Loss
Serial Number(S) (required)
Replacement/Repair (required)

Cause of Loss
(Mark All That Apply)

Fire: Fire
Roof Leak: Roof Leak
Tornado: Tornado
Lightning Power Surge: Lightning Power Surge
Pipe Leakage: Pipe Lea kage
Theft: Theft
Water Roof Leak: Water Roof Leak
Flood: Flood
Elec. Failure/Disturbance:Elec. Failure/Disturbance
Utility Interruption:Utility Interruption
Other: Other

Required Paperwork to Be Returned

Service Report: Service Report
Police Report : Police Report
Replacement Invoice: Replacement Invoice
Fire Report: Fire Report
Repair Invoice:Repair Invoice

Inaccurate or incomplete report will slow the claim process.