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Instant
Roof Estimates
Step
1
of
6
16%
Name
*
First
Last
Phone
*
Email
*
Date of Loss
*
MM slash DD slash YYYY
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Insurance Company
*
First Choice
Second Choice
Third Choice
Claim Number
*
Claim Adjuster Name
First
Last
Adjuster Phone
*
Adjuster Email
*
Total Squares
*
Please enter a number from
1
to
100
.
Shingle Type
*
3-Tab
Laminated Architectural
Laminated Class IV - Impact Resistant
Continuous Ridge Vents (LF)
*
Please enter a number from
1
to
500
.
Roof Pitch 7/12-9/12 Slope
Please enter a number from
0
to
100
.
Roof Pitch 10/12-12/12 Slope
Please enter a number from
0
to
100
.
Roof Pitch 13/12 - 15/12 Slope
Please enter a number from
0
to
100
.
Does your home have more than 1 story?
*
Yes
No
Number of Squares on 2nd Story
*
Please enter 0 if your home doesn't have a 2nd story.
Replacement Cost Value (RCV) of Roof ONLY
*
Total Replacement Cost Value (RCV) of ALL Items
*
Deductible
*
Total NET CLAIM
*
Please upload your claim documents if possible. You can also email them after you submit this form.
Max. file size: 256 MB.
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