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Claim Form

This form is to be completed in the event of a loss or damage to company property. As part of an insured’s duties in managing a property claim, it is imperative the following steps are taken once a loss has occurred:

  • Make repairs if reasonable and necessary to protect the property from further damage
  • Maintain a record of all expenses incurred protecting the property
  • Separate damaged from undamaged personal property, if possible
  • Take photos of the damaged property

For more information you can contact Franklin Street Insurance Services at

Date of Loss

Company Information

Is there any Flood Damage?

Has Emergency Services Contractor been retained to date?

Description of Physical Damage to Location(s)