Submit a New Salvage Assignment

If you have any questions regarding submission of a new assignment, please feel free to send us a message.

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Client / Adjuster Name

First

Last

Client / Adjuster Company

Client / Adjuster Street Address or PO Box

Client / Adjuster City, State, & Zip Code

Client / Adjuster Phone Number

Client / Adjuster Email

Confirm Email

Insured Contact Name

First

Last

Insured Company

Insured Contact Phone Number

Insured Contact Email

Confirm Email

Claimant Contact Name - If Applicable

First

Last

Claimant Company - If Applicable

Claimant Contact Phone Number - If Applicable

Claimant Contact Email - If Applicable

Confirm Email

Claim Number or ID

Damage Type - Lighting, Fire, Water, Theft, Etc.

Property Type - Electronics, Medical Equipment, Dental Equipment, Etc.

Loss Address / Location

Additional Notes

Do you have documentation or photos?

Office
17A River Road
Lisbon, CT 06351