Non-Profit Insurance Claim
Non-Profit Insurance Claim
I. Claimant Information
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Organization Name: |
[Your Company Name] |
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Contact Person: |
[Your Name] |
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Phone Number: |
[Your Company Number] |
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Email Address: |
[Your Email] |
II. Incident Description
On the date of October 15, 2053, at approximately 2:30 PM, a severe storm caused significant damage to the roof of our community center located at [Your Company Address]. High winds coupled with heavy rain resulted in the partial collapse of the roof, leading to water intrusion into several rooms used for our outreach programs.
III. Damage Assessment
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Roof: Severe structural damage and partial collapse.
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Interior Walls: Water damage to drywall and insulation in multiple rooms.
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Flooring: Water damage to carpeting and hardwood floors in affected areas.
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Equipment: Damage to various pieces of electrical equipment including computers, projectors, and sound systems.
IV. Policy Information
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Policy Number: |
NP123456789 |
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Insurance Provider: |
Goodwill Insurance Co. |
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Policy Type: |
Comprehensive Property and Liability Insurance |
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Coverage Period: |
January 1, 2053 - December 31, 2053 |
V. Supporting Documents
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Incident Report: A detailed report documenting the storm's impact, including the date, time, and nature of the damage. This report provides context and verification of the incident.
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Photos of Damage: Visual evidence of the damage to the roof, interior walls, flooring, and equipment. These photos help illustrate the extent of the damage.
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Roof Repair Estimate: A professional estimate detailing the cost to repair the roof, including labor and materials.
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Water Damage Restoration Estimate: An estimate for restoring water-damaged areas, including the cost of drying, cleaning, and replacing affected materials.
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Equipment Repair/Replacement Quotes: Quotes from service providers for repairing or replacing damaged electrical equipment, such as computers, projectors, and sound systems.
VI. Claim Amount
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Roof Repair: |
$25,000 |
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Water Damage Restoration: |
$15,000 |
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Equipment Repair/Replacement: |
$10,000 |
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Total Claim Amount: |
$50,000 |
VII. Declaration and Signature
I, [Your Name], hereby declare that the information provided in this claim is accurate and complete to the best of my knowledge. I agree to cooperate with Goodwill Insurance Co. and provide any additional documentation or information required during the processing of this claim.
[Your Name]
[Date Signed]
