Insured’s checklist:

Insured First and Last Name:____________________________ Date:____________________

Before Packout:

[  ]   [Your Company] staff made me aware the process.

[  ]   [Your Company] staff made me aware that I must remove the high value items such as cash/Jewelry/Medications/credit cards/passport/Firearms/Any DANGEROUS and ILLEGAL Contents.
[  ]   I have informed the [Your Company] staff about the sentimental and rush contents. [  ]   I will NOT hold [Your Company] responsible for disposing the non salvageable contents other than what I have outlined in the sentimental form.
[  ]   I have informed the [Your Company] staff about all the damaged items during packout and they have removed /assessed everything as per my request.
[  ]   Special instructions on dry cleaning. Allergy reactions to any laundry detergent? If Yes please specify the detergent make and Model you use ………………………..
[  ]   Regarding pre packed contents, I………………………………….. Confirm there are no dangerous goods, weapons, flammable or poisonous goods.  Also [Your Company] is not liable for items packaged by me and that I waived the offer to repackage them.
[  ]   I…………………………………………………the undersigned the policy holder confirm all the contents are belongs to me and part of the claim. I have NOT included any contents that are belongs to the landlord or tenants.
[  ]   I authorize [Your Company] to list and document the contents and provide me with the online access to view the contents.

Before Packback:

[  ]   [Your Company] staff made me aware that there is no warranty covered for any claim related issues if set up declined by me. And I am fully aware that [Your Company] is NOT responsible for any damaged or missing contents if set up declined by me.
[  ]   Regardless setup declined, [Your Company] staff still verified all the contents to show nothing missing or broken and all contents are in good working condition.

After Packout or Packback:

[  ]   Satisfied with the quality of the contents restoration?
[  ]   How was your initial experience?.....................................................................
[  ]   How well [Your Company] staff conducted themselves during pack out or pack back. Anyone in particular? …………………………………...
[  ]   Would you recommend our services to others? .......................................................
[  ]   Comparisons to others who are involved in your claim …………………………………
[  ]   Satisfied with the Customer service provided by the Office Staff? ………………………
[  ]   Have you reviewed the contents using ICAT web portal and how was your experience? ............................
[  ]   No damage done to the property by [Your Company] staff or any of their sub trades.

Any Other Comments:

……………………………………………………. …………………………………………………….

Road Lead’s Full Name & Signature

……………………………………………………… ………………………………………………………

Insured’s Full Name & Signature

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