The ARC Advantage!      "One Contact... One Call... Handles it All!

                    

 
 

 

 

 

 

 

 

Specializing in ...

Storm     •      Fire      •      Water     •     Mold

Remodeling      •      New Construction      •      Design/Build
 
 

Insurance

  
 

Dear Adjuster/Agent:

 

Please fill out this
form entirely and
submit.


We will contact you
and the client within
60 min. if submitted
during normal
business hours.
8am - 5pm CST.


If this an emergency
and is not between
normal business
hours, please call:
(636) 946-7855


We will provide a
detailed, line item
Xactimate estimate
in your hands within
48 hours of
submittal.


Thank You for your
business!

 

  

 

XPRESS CLAIM

In the event of an emergency response, please do NOT use this form.  Contact our 24 hour hotline ANYTIME!

(636) 946-7855 - ARC is here when you need them!

 

Loss Information

    

 

Date of Loss:

 

 

 

Property Type:

 

 

 

 

Loss Type:

Fire Damage

Flood Damage

Hail Damage

Mold Remediation

 

Water Damage

Wind Damage

Other 

Description / Comments:

 

 

 

 

 

Insurance Information

      

Insurance:

 

 

 

Adjuster Information

  

 

 

 

Adjuster Name:

 

 

 

Phone Number:

Cell Number:

 

Fax Number:

E-mail Address:

 

Additional Comments:

 

 

 

 

 

Insured Information

    

 

Name:

 

 

 

Address of Loss:

 

 

City:

 

 

 

State:

ZIP Code:

 

Phone Number:

Cell Number:

 

Fax Number:

E-mail Address:

 

Additional Comments:

 

 

 
 

Copyright © 2006 American Restoration Contractors.  Last modified: 10/24/07 - Website by: www.LandgrafYBE.com