Assign a New File - LWG Consulting

You may assign us new projects on-line. Our consultant will contact you within 24 hours of submission of your request. If this is an emergency, please call our 24-hour response line at (800)326-5075.

Your name:
E-mail address:
	*please note that a valid e-mail address is required
Company name:
Company address:
Phone number:
Fax number:

Claim Information:

Claim number:
Date of loss:
Insured's name:
Insured's address:
Contact at insured:
Insured's phone no:
Insured's fax no:

Loss Details:

Loss type:

Breakdown	Contamination	Fire
Handling	Lightning	Natural disaster
Power surge	Theft	Vandalism
Water	Miscellaneous

Valuation:

Actual Cash Value	Business Interruption
New Replacement Cost	Used Replacement Cost
Extra Expense

Type of equipment:

Audio	Printing	Computers
HVAC	Office	Manufacturing
UPS/Surge	Satellite	Pumps
ATM/POS	Medical	Security System
Data Comm	Phones	Semiconductor
TV/Radio	Test/Lab	Others

What do you want us to do?

Site Inspection	Restoration
Determine cause	Expert Witness
Salvage	Manage Restoration
Review Documents	Meet with client
Perform replacement	Determine repairability
Get replacement costs	Lightning verification
Determine extent of damage	Monitor work performed
Computer Forensics	Data Recovery
Others (please write in comments)

Additional comments:

Contact Insured? Yes No

Discuss budget before starting? Yes No

Are there any other parties involved? Yes No