FPG Corporation, or their representative is hereby retained to advise and assist in the adjustment of the insurance claim arising from loss by which we received on the day of , 20 . The Insured agrees and understands FPG Corporation will be paid 10% of the total amount o f money FPG re cov er s f rom th e insuranc e company on th is claim not to exceed 10%. This fee can be paid by the General contractor or insured. If the fight is only for general contractors overhead and profit or if this is only appraisal the fee will be 20%.
FPG is excluded from any monies paid to the insured prior to being hired by the insured.
The fee shall be due after proof of loss is sworn to and/or first proceeds issued... The fee of FPG Corporation shall be due after each draft collected and in the percentage listed in the contract. If this goes to litigation 10% still applies.
Please include the name of FPG Corporation, in addition to the Insured’s name, on all drafts or checks pertaining to this loss. (Please mail the check to the Insured.)
The insured acknowledges receipt of a copy of this, FPG Corporation, Public Adjusters Contract.
This agreement containsthe whole contract between the parties hereto and shall not be changed, altered or amended. The adjuster has read and explained this contract to me in its entirety .
Public Adjuster’s Signature:
Insured’s or Contractors Signature:
Public Adjuster’s Printed Name:
Insured’s Printed Name:
Date (Month/Day/Year):
Address:
Telephone Number:
PA Insurance license Number:
You, the insured, may cancel this contract at any time prior to midnight on the fourth calendar day after the execution date of this contract. If you exercise your right to cancel this contract, you will be liable to FPG Corporation the cost for work that was completed on the claim. Cancelation must be in writing.
This is to certify that Financial Protection Group, Public Adjusters and their representatives, are hereby retained to advise and assist in the adjustment of the insurance claim arising from loss by which occurred at the following address Initially reported to FPG on day of , 20 . (date of loss to be calculated by forensic weather analysis) to assist in the processing of the settlement checks. Additionally, communications for my claim will be done directly through Financial Protection Group, Public Adjusters and their representatives.
Ins
By my/our signature(s) below, I/ we hereby authorize the name of Financial Protection Group to be on all checks and drafts pertaining to this loss, and to forward same to Financial Protection Group, office of Public Adjusters, 115 W Adams St, Purcell Ok 73080
By Signature:
Insured Signature:
Print
X
Oklahoma Law SB 439 States defines specifics according to the law regarding certain elements be added to the Public Adjuster Contract, it does not however, grant the Insurance Company the authority to demand the contract. If you The Insurance Company would like a copy of our contract, please contact The Oklahoma Insurance Commission at 400 NE 50th St, Oklahoma City, OK 73105. We welcome any person(s) to report any and all violations of insurance law to the insurance commission.
