Request for Services Form - McMartin, Wasek & Associates, Inc.

Standard Services

____ ¨ Full Adjustment

____ ¨ Content Adjustment
___ Full Adjustment
___ Scope Only
___ Spatial Analysis
___ Audit

____ ¨ Agreed Damage Appraisal
___ Determine cause
___ Agreed Estimate, Valuation Consideration,
and Photographs
___ Determination of ACV and RCV losses
___ Short Transmittal Report

_____ ¨ CAT Loss
___ Agreed Estimate
___ Photograph
___ Short Transmittal Report

____ ¨ Forensic Accounting
___ Business Interruption
___ Work Loss / PIP
___ Survivors Loss
___ Employee Dishonesty
___ Theft
___ Liability

Schedule of Task Services

· ____ Cause and Origin Investigation

___ Experts as Needed: Engineer, C&O, HVAC, Accountant
___ Statements
___ Neighborhood Canvas
___ Subrogation Evaluation

· ____ Guaranteed Replacement Cost Analysis
___ Xactimate Replacement Cost Valuation
___ Diagram with 3D Imaging
___ Material List
___ Xactimate Replacement Cost Estimate

Schedule of Other Services

                 ____ Public Records – Police, Fire, Other
                 ____ Title Search
                  ____ Market Value Appraisal
                 ____ PILR
                 ____ Other: _______________________

                    ____ Agreed Estimate Only
                     ____ Photographs
                    ____ Salvage Evaluation and Disposal
                    ____ Xactimate Training

Please choose the services needed and fax to 989.893.0208

               P.O. Box 2058                                     P.O. Box 888364                                     10370 Citation Drive, Suite 100
               Bay City, Michigan 48707-2058        Grand Rapids, Michigan 49588             Brighton, Michigan 48116
               Phone 989.893.0137                           Phone 866.937.7008                               Phone 810.229.7860
               Fax 989.893.0208                               Fax 989.893.0208                                   Fax 810.229.8036