Free Non-Profit Insurance Claim

I. Claimant Information

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

• Roof: Severe structural damage and partial collapse.

• Interior Walls: Water damage to drywall and insulation in multiple rooms.

• Flooring: Water damage to carpeting and hardwood floors in affected areas.

• Equipment: Damage to various pieces of electrical equipment including computers, projectors, and sound systems.

IV. Policy Information

V. Supporting Documents

• 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.

• 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.

• Roof Repair Estimate: A professional estimate detailing the cost to repair the roof, including labor and materials.

• Water Damage Restoration Estimate: An estimate for restoring water-damaged areas, including the cost of drying, cleaning, and replacing affected materials.

• 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

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]

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