Claims Inquiry – Boggs Inspection Services

Your Email *

Date / Time of Inspection *

Date

Time

Property Owner *

First

Last

Date of Pre-Closing Inspection *

Date

Time

Property Address *

Address Line 1

Address Line 2

City

State

Zip Code

Move-In Date *

List Price of Property *

Sale Price of Property *

Contact Number *

Did you purchase a warranty plan?

Date Purchased

Warranty Business Phone Number

Homeowner Policy #

Insurance Company

Effective Date of Policy

Description of Incident/Condition (be as detailed as possible) *

Was incident/condition visible during the home inspection? *

Date you became aware of the condition *

Did you learn about this condition prior to closing?

If yes, was the condition identified?

Did you conduct a final walkthrough prior to closing? *

Yes
No

If yes, please leave a detailed description as to how became aware.

Did the seller provide any disclosure form? *

Yes
No

If yes, was the condition identified in the disclosure?

Yes
No

Did you conduct a final or pre-closing inspection?

If yes, was the condition/incident visible at this inspection?

If no, why not?

If you did not notice the condition yourself, who first observed and informed you of it?

Was any action taken on this condition prior to closing? *

Yes
No

After closing? *

Yes
No

If yes, please leave a detailed description as to what occurred?

Did other service providers perform any other inspections/services as part of the purchase process? *

Yes
No

If yes, who and what did they do?

Did you negotiate with Sellers based on any findings of Home inspection?

If yes, how much did you negotiate and for what issues/items?

Please provide additional comments regarding your knowledge of the condition:

Provide contact information for any contractors, servicepersons or other individuals that have identified, inspected or donework related to the conditions/concerns reported above?

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

What were their comments?

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

What were their comments?

Did you obtain an estimate or proposal to correct condition?

Yes
No

Amount of Estimate/Proposal

Has any work been done?

Yes
No

If yes, please explain the work completed

Please upload all copies of reports and documents from service companies

Drag & Drop Files, Choose Files to Upload

What day did you receive these documents?

Name of Homeowner *

First

Last

Today's Date *

Please upload any pictures of receipts of work

Drag & Drop Files, Choose Files to Upload