Attn: Claims Services Legal Services - Risk Management 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Type of Claim' section, selecting either Equipment Breakdown or Property.
3. In the 'INSURED' section, provide the name of the entity and contact details including first and last names, telephone numbers, and email addresses.
4. Describe the damaged property by entering its address, city, state, and zip code.
5. Detail when and how the loss occurred. If the exact date is unknown, provide the date of discovery along with a description of the accident or activity.
6. List all damaged or stolen property with relevant details such as name, model, serial number, approximate age, and replacement cost.
7. Complete the financial estimates for building damage, contents lost, and any other relevant costs while ensuring to include deductibles.
8. If applicable, report any crime losses to police and include their report number in the designated fields.
9. Finally, ensure that authorized representatives sign and date the form before submission.

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