CERTIFICATE OF SATISFACTION

Insured:  Loss Address:  

 
   

Phone Number: Alternate Number:    Claim Number: Policy Number:  

I, hereby state that EXECUTIVE CLAIM SOLUTIONS has completed emergency services, water mitigation, and/or mold remediation at the address listed above to my satisfaction. As the Insured/Owner/Agent of the above-listed property.

By signing this document, I agree to cooperate with EXECUTIVE CLAIM SOLUTIONS, the insurance company, and any other responsible parties in regard to obtaining and securing payment for work performed at my property listed above.

All workmanship is guaranteed for three (3) years.

Property Owner Signature

Date

Property Owner Printed Name

Date

Signature of EXECUTIVE CLAIM SOLUTIONS Date

Survey: 1 =Very Unsatisfactory 2 =Unsatisfactory 3 =Neutral 4 =Satisfactory 5=Very Satisfactory

  1. Were the employees professional?   
  2. Overall, how satisfied were you with the contractor? 
  • Was the work completed in the timeframe communicated? 
  • How satisfied are you with the referral program offered by your insurance company?     

Comments:

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