NEW INSURANCE CLAIM – FLETCHER LEGAL

ARP-FL CONTRACT FOR SERVICES

USED WITH NEW CLIENTS TO ASSIST WITH PROPERTY DAMAGE RESTORATION CLAIMS.

3rd PARTY EMAIL RECIPIENT

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County

Select CFC Representative Initiating New Claim Select CFC Representative Initiating New Claim

Email Address of CFC Representative

Date of First Client Contact

Date of Loss

Age of Roof

Cause of Loss

Does Insurance Company have Permission to Conduct Remote Drone Fly-Over?

Yes

Is Roof Steeper than Average Home’s Main Staircase?

Yes

Number of Floors in Home

Estimated Roof Pitch

Referral Source

Shingle Choice

Special Areas of Attention

Estimate of Fletcher Legal’s Reimburseable Expenses

Estimate of Carolina First’s Reimburseable Expenses

Anticipated Out-of-Pocket Homeowner Cost