Increased Cost of Compliance Proof of Loss FEMA Form 086-0-10 (4/17)
This form is used by the policyholder to make their statement of the amount for an Increased Cost of Compliance claim with sworn details of loss.
PDF (185KB)
Catastrophe
Property
Forms Flood
Worksheet-Building FEMA Form 086-0-7 (4/17)
This form is used by adjusters and policyholders to list and assess the scope of flood damaged building property.
PDF (383KB)
Catastrophe
Property
Forms Flood
Non-Waiver Agreement / Reservation Of Rights (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (65KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
Flood Zone Classification Chart
Definitions of flood zone classifications.
PDF (14KB)
Auto
Catastrophe
Property
General Reference
The Saffir-Simpson Hurricane Scale
The Saffir-Simpson Hurricane Scale is a 1-5 rating based on the hurricane’s present intensity
PDF (14KB)
Catastrophe
Property
General Reference
Excavation-One Call Centers Nationwide
A resource for excavation professionals or anyone who has to dig, includes the One-Call Center directory for utility locating services in all of the United States.
PDF (545KB)
Liability
Property
Legal Reference
Sworn Statement In Proof Of Loss (No Subrogation) (Spanish)
A notarized statement of the money requested for a loss under a property coverage policy.
PDF (85KB)
Property
Forms Property & Casualty
Increased Cost of Compliance (ICC) Adjusters Report FEMA Form 086-0-19 (4/17)
This form provides FEMA with information regarding substantial damage, mitigation measures, repetitive loss and cost associated with compliance to floodplain management ordinances.
PDF (401KB)
Catastrophe
Property
Forms Flood
CEA 04A Endorsement Coverage for Breakables
A sample California Earthquake Authority (CEA) endorsement which provides a optional coverage to forms BEQ-3B, BEQ-3C, BEQ-6B, and BEQ-4B. Sold and serviced by participating insurance companies.
PDF (657.99KB)
Catastrophe
Property
Policy Forms
CEA 03A Endorsement Coverage for Exterior Masonry Veneer
A sample California Earthquake Authority (CEA) endorsement, which provides homeowners optional coverage for exterior masonry veneer, to be used with forms BEQ-3B and BEQ-3. Sold and serviced by participating insurance companies.
PDF (KB)
Catastrophe
Property
Policy Forms
Emergency / Temporary Work Repair Summary (Spanish)
An emergency/temporary repair work order, including cost, provided in support of a property claim.
PDF (35KB)
Property
Spanish
Forms Property & Casualty
