Corporation Insurance Claim
Corporation Insurance Claim
1. Policyholder Information
Please provide the following details about your corporation.
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Field |
Details |
|---|---|
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Corporation Name |
[Your Company Name] |
|
|
[Your Email] |
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Policy Number |
094-323-10 |
2. Incident Information
Please describe the incident that led to the claim.
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Type of Incident: July 29, 2051
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Date and Time:2:30 PM
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Location: 123 Innovation Drive, Tech City, CA 90001
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Description: On July 29, 2051, a severe thunderstorm caused significant water damage to our server room at the above address. The roof developed leaks, resulting in water dripping onto several critical servers and IT equipment.
3. Damaged Property Information
Provide the details of the property damaged in the incident.
|
Description |
Details |
|---|---|
|
Description of Damage/Loss |
Severe water damage to the server room, impacting the primary server rack, network switches, and storage units. |
|
Estimated Cost of Repairs/Replacement |
$25,000 (Detailed estimate attached) |
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Supporting Documents |
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4. Witnesses or Additional Information:
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Witnesses: Written accounts from witnesses providing their observations and insights into the incident.
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Additional Information: Due to the severity of the damage, our IT operations have been temporarily relocated to an offsite facility to ensure business continuity. We are closely collaborating with IT Tech Repair Services to expedite repairs and mitigate further losses.
5. Signature and Authorization:
As the Chief Operating Officer of the company, I hereby affirm and declare that, to the best of my knowledge, the information provided in this document is both accurate and complete.
[Your Name]
[Date]
