specialty valuations, specialty vehicles, special service - valu … · 2019. 6. 4. ·...
TRANSCRIPT
Body Type Axle Configuration GVWR Overall ConditionExcellent Above Avg Average Below Avg Poor
Claim Information
VALU-RITE Request Form Non-Commercial Trailer
Email to [email protected] Enter Online at www.dcisolution.com
Fax to (855)324-5465
Customer Claim Number Customer Reference Loss Date Type of Loss Prior Damage/Other Deductions
TheftFloodFireCollision
Claim RepCompany Claim Rep Name Claim Rep Email Claim Rep Phone
Owner/InsuredOwner Name Owner Phone Owner Email Can DCI contact owner?
Yes No
Owner City Owner State Owner Zip Sales Tax Rate %
Service Requested
Type of Vehicle
Vehicle/Asset
Trailer Types
Tires/Axles
Total Loss ValuationGuaranteed Salvage Bid*Cost AuditFull AppraisalDiminished Value*Collision Estimate
* Salvage Bids and Diminished Value requests require a photo and estimate.
Non-Commercial Trailer
VIN Year Make Model Series
Truck/Trailer Body Options
Comments/Additional Info:
*Please do not include maintenance receipts.
Pictures Receipts* from owner
Paint ConditionExcellent Above Avg Average Below Avg Poor
Exterior Features
DCI Solution 2016 All Rights Reserved 0816
Please include date & cost on upgrades /add-ons.
Trailer Body FeaturesSpare Tire
OtherBarn DoorsRear RampRoll-UpSwing
Side Door (Qty )
Rear Door
Side Rails (Height ) OtherBeavertailSideDrop DownPull OutRamps
Composition Deck LiningAluminumSteelAluminum/SteelOther
AluminumSteelWoodOther
Aluminum
OtherWood
Repainted Date CostYes No
Trailer Body TypeCargo UtilityDump SkidFlatbed Car Hauler Boat Horse ATV/Motorcycle Other
Bumper PullV-NoseGooseneck5th WheelPartialFullTiltEnclosedOpen
Length Width Side Wall Height Capacity Contents Hauled
Interior FeaturesInterior Condition
Excellent Above Avg Average Below Avg Poor
I/S Wheel Type QtyAluminum Steel Alum/Steel
Rear Tire Size Qty Rear Tire Tread RemainingNew 90% 80% 70% 60% 50% 40% 30% 20% 10%
Axle ConfigurationSingle Tandem
Rear Axle Rating
O/S Wheel Type QtyAluminum Steel Alum/Steel
Super Single
Suspension TorsionSpring
Powertrain
AccessoriesE-Track Railgate (Capacity lbs.)Ladder Rack Tarp System
ElectricManual
D-Rings (Qty )Spare Tire
Tongue JackPowerManual
Power Roof Vents (Qty )
Tool Box 1 Tool Box 2Steel Aluminum
Dimensions:
Date/Cost:
Steel Aluminum
Dimensions:
Date/Cost:
* Please put additional tool boxes in Comments/Additional Info Box above.