Submit Assignment - Insurance Related

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Your Contact Information
Street Address
Description of Assignment
Type of Loss *

Eg: Building Consulting, EHS Services, Engineering, etc.

To upload multiple files, select them at the same time. To clear selected files click "choose files" and then "cancel". Accepted file types: image, pdf, word doc, text file. Maximum upload size: 25MB. If you need to upload more than 25MB, please contact us at [email protected].

Loss Information

If not generated yet, please enter "TBD"

Loss Location(s)
Loss Locations
No Project Address?
Independent Adjusters

If you are an independent adjuster submitting this assignment, complete insurance carrier information below.

Insurance Carriers
Assignment Contact(s)
Assignment Contact(s)
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