Xactnet Address:

Adjuster Licenses (List State Number)

Are you Flood Certified? Choose One: Yes No FLN Number:

FLN Certifications:

Residential:	Choose One: Yes No
MH:	Choose One: Yes No
Small Commercial:	Choose One: Yes No
Large Commercial:	Choose One: Yes No
RCBAP:	Choose One: Yes No

Carrier Certifications:

Adjusting Experience (years):

Cat:
Daily:
Flood:
Wind/Hail:
Fire:
Water:

Sofware Capabilities):

Xactanalysis:	Choose One: Yes No
Xactimate:	Choose One: Yes No
Filetrac:	Choose One: Yes No
Word:	Choose One: Yes No
Sketch:	Choose One: Yes No
Simsol:	Choose One: Yes No
Excel:	Choose One: Yes No
PDF:	Choose One: Yes No

Preferred Work (Rank 1-2-3):

Daily: Cat: Flood:

 

Type of work (Rank 1-2-3-4):

Field Adjuster: File Reviewer:

Team Leader : Flood Adjuster :

 

References (List):

Name:	Company:	Phone Number:

Other Information

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