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Commercial Property Claim Report Form

Basic Claim Details

 

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Insured Data

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Please do not include hyphens
 
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Client Codes:

 
 
 
 

Loss Details

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Type of Loss:
 
 
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Coverage Information

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Fire, Allied Lines Multi-Peril Policies (complete only those items involved in loss)

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Insert form numbers, edition dates and special deductibles
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List companies, policy nos., coverages and policy amounts
 
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