Home - All Claims Consulting

(Here In After “Insured” retains All Claims Adjusting to advise and assist in the measurement and documentation of the Insured’s loss, and to present Insured’s claim to the insurance company for loss and damages from the danger/peril of
that was sustained by insured’s property located at
The insurer is (Homeowner Name)
With the claim number
Insured agrees to pay and assigns to All Claims Adjusting for services rendered on behalf of Insured 5% or $500.00 (Whichever is Greater) of the amount received from the insurer by the Insured for services rendered to the Insured.
Effective date of this contract: (Date).
Date Format: MM slash DD slash YYYY
You may cancel this contract at any time before midnight of the third business day after the date you sign and are provided with a copy of this contract.
- Signature of Insured
- Date
  Date Format: MM slash DD slash YYYY
- All Claims Adjusting (Representative)
- Date
  Date Format: MM slash DD slash YYYY