Insurance Restoration Contract

INSURANCE RESTORATION CONTRACT

Parties and Identifying Information

Insured / Policyholder Name:

Insured Date of Birth:    Phone:

Contact Person:    License No.:

Insurance Policy & Claim Details

Insurance Company:

Policy Number:    Policy Type: Homeowners   Dwelling   Commercial

Coverage Limit: $    Deductible: $    Premium: $

Policy Period From: to

Claim / Loss Information

Date of Loss:    Claim Number:

Documentation Provided (check all that apply):

Photos of loss/damage    Police/fire report    Receipts/invoices
Prior repair estimate    Proof of ownership

Scope of Work and Estimate

The Contractor agrees to perform restoration, mitigation and repair services described below in a professional manner in accordance with industry standards and applicable law. Detailed scope and pricing are set forth as follows:

Itemized Estimate

Labor: $    Materials: $    Equipment: $

Permit / Inspection Fees: $    Other: $    Total Estimated Cost: $

Coverage, Assignment & Payment Authorization

The Insured hereby authorizes the Contractor to perform the work described above and to submit claims, estimates, invoices and documentation to the Insured's insurer. The Insured elects (select one):

Insurance proceeds payable to Insured (Contractor will invoice Insured)    Assign insurance proceeds to Contractor (Assignment of Benefits)

Assignment Percentage to Payee: %

Coverage & Services Checklist

The Contractor will provide the following services as applicable (check all that apply):

Structural repair    Contents restoration    Water extraction
Mold remediation    Smoke & soot cleaning    Temporary housing coordination
Emergency board-up / tarping    Debris removal

Exclusions

The following items are expressly excluded from this Agreement unless separately agreed in writing: (a) pre-existing damage or conditions that predate the Date of Loss; (b) work required to bring the property into compliance with changes in building codes unless specifically authorized and priced as a change order; (c) pest, termite or dry-rot abatement unless separately contracted; (d) hazardous material abatement (including asbestos, lead, PCBs) unless contractor is specifically qualified and costs are separately agreed; (e) cosmetic-only repairs not associated with covered loss; and (f) delays or costs caused by insurer disputes or withholding of funds.

Warranties; Insurance; Licenses

Contractor warrants that work performed under this Agreement will be free from defects in workmanship for a period of months from completion, subject to normal wear and tear and excluding items outside contractor control. Contractor certifies it holds current licenses and shall maintain general liability insurance with limits of at least $ and workers' compensation as required by law.

Indemnification; Limitation of Liability

To the extent permitted by law, Contractor shall indemnify and hold harmless the Insured from claims, liabilities and costs arising from Contractor's negligent acts or omissions in the performance of work under this Agreement. Contractor's total liability for any claim, whether in contract, tort or otherwise, shall not exceed the greater of the total contract price paid to Contractor under this Agreement or the amount recoverable from Contractor's insurance applicable to such claim.

Change Orders; Delays

Any modification to the Scope of Work or pricing shall be documented as a written change order signed by both parties. Contractor shall not be liable for delays caused by the insurer, unavailability of materials, hidden conditions, or other causes beyond Contractor's reasonable control; such delays may extend the completion schedule and increase cost.

Termination

Either party may terminate this Agreement for material breach after providing ten (10) days' written notice and an opportunity to cure. Upon termination, Contractor shall be entitled to payment for work performed and materials purchased to date, including reasonable demobilization costs.

Notices

All notices required by this Agreement shall be in writing and delivered to the addresses set forth above by personal delivery, certified mail, or overnight courier. Notice is effective upon receipt.

Certification and Authorization

By signing below, the Insured certifies that the information provided herein is true and accurate to the best of their knowledge, authorizes Contractor to perform the authorized work, and understands that the Insured remains financially responsible for any deductible, non-covered charges, and obligations not paid by the insurer. The Insured authorizes Contractor to coordinate with the insurer, adjuster, and other parties necessary for restoration of the property.

Additional Remarks

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