Public Adjuster Agreement

PUBLIC ADJUSTER AGREEMENT

This Public Adjuster Agreement (the "Agreement") is made effective as of between Client Name: (the "Insured") and Public Adjuster Name: (the "Adjuster").

RECITALS

WHEREAS, the Insured has suffered loss or damage to property located at and intends to submit a claim under one or more insurance policies; and

WHEREAS, the Adjuster is duly licensed and experienced in adjusting, evaluating and negotiating insurance claims on behalf of insureds; and

WHEREAS, the Insured desires to engage the Adjuster to represent the Insured's interests in presenting, prosecuting and negotiating the insurance claim subject to the terms set forth herein.

NOW THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the parties agree as follows:

1. APPOINTMENT; SCOPE OF ENGAGEMENT

The Insured hereby retains and appoints the Adjuster as the exclusive public adjuster to assist, prepare, present, adjust and negotiate the insurance claim described in the Recitals ("Claim") with the Insured's insurer(s). The Adjuster shall act on behalf of the Insured only in accordance with the authority expressly granted in this Agreement and shall perform services including, but not limited to, policy and coverage review, loss documentation, scope and estimate preparation, submission of proofs of loss, meeting with the insurer and its representatives, and negotiation of settlement.

2. ADJUSTER AUTHORITY

The Insured grants the Adjuster authority to: (a) obtain and review copies of the Insured's insurance policy and claim file; (b) authorize inspections and investigations; (c) obtain estimates and documentation from contractors and consultants; and (d) negotiate settlement of the Claim subject to the Insured's written approval for any settlement amount in excess of $. The Adjuster shall not bind the Insured to any settlement or admission without prior written consent of the Insured, except as expressly authorized in writing.

3. ADJUSTER DUTIES; STANDARD OF CARE

The Adjuster shall perform services in a professional manner consistent with the standards of the public adjusting profession and applicable licensing laws. The Adjuster shall keep the Insured informed in writing of material developments, provide copies of correspondence and offers, and furnish final accounting of compensation and disbursements upon request or upon conclusion of the Claim.

4. FEES AND PAYMENT

The Insured shall compensate the Adjuster as follows (select applicable fee structure):

The contingency fee, if selected, shall be computed on the gross amount of recovery before deducting any costs or attorney fees unless otherwise agreed in writing. Payment to the Adjuster shall be due within days of receipt of settlement proceeds by the Insured. The Insured authorizes the Adjuster to deduct fees and approved expenses from any settlement proceeds prior to disbursement to the Insured, provided such deduction is expressly permitted by law and supported by written accounting.

5. COSTS AND EXPENSES

The Insured shall be responsible for out-of-pocket costs and expenses reasonably incurred by the Adjuster in the prosecution of the Claim, including, but not limited to, fees for experts, engineers,photographers, document reproduction, travel and postage. Such costs shall be preauthorized in writing if anticipated to exceed $ unless otherwise agreed.

6. TERM; TERMINATION

This Agreement commences on the effective date and continues until the Claim is finally resolved and all payments are disbursed, unless earlier terminated. Either party may terminate this Agreement upon days' written notice to the other. Termination does not affect the Adjuster's right to fees or reimbursement for work performed prior to termination on a quantum meruit basis if fees are disputed.

7. CONFIDENTIALITY

The Adjuster shall maintain in confidence all nonpublic information obtained in connection with the Claim, except to the extent disclosure is necessary to carry out the Adjuster's duties, is required by law, or is consented to in writing by the Insured. Confidential documents provided to the Adjuster remain the property of the Insured.

8. CONFLICTS OF INTEREST; REPRESENTATIONS

The Adjuster represents that it has no known conflicts of interest that would materially impair its ability to represent the Insured. The Adjuster will disclose any potential conflicts that arise during the engagement and will obtain the Insured's written consent before continuing representation if a material conflict exists.

9. RECORDS; ACCOUNTING

The Adjuster shall maintain records of all activities performed and all receipts and disbursements relating to the Claim. Within a reasonable time after final resolution of the Claim or upon request, the Adjuster shall deliver a final settlement statement and supporting documentation to the Insured.

10. INDEMNIFICATION; LIMITATION OF LIABILITY

The Insured shall indemnify and hold harmless the Adjuster for claims arising from the Insured's negligent misrepresentations, failure to disclose material facts, or unauthorized acts. Except for willful misconduct or gross negligence, the Adjuster's liability to the Insured for any claim arising under this Agreement shall be limited to the amount of fees actually paid to the Adjuster under this Agreement.

11. NOTICES

All notices, requests, demands and other communications under this Agreement shall be in writing and shall be delivered to the following addresses by hand, certified mail (return receipt requested), or overnight courier:

12. AMENDMENT; WAIVER

No modification, amendment or waiver of any provision of this Agreement shall be effective unless in a writing signed by both parties. No failure or delay in exercising any right shall operate as a waiver of that right.

13. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of law principles. The parties submit to the exclusive jurisdiction of the state and federal courts located in that State for disputes arising under this Agreement.

14. ENTIRE AGREEMENT; SEVERABILITY; COUNTERPARTS

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings and agreements. If any provision of this Agreement is held invalid or unenforceable, the remainder of the Agreement shall remain in full force and effect. This Agreement may be executed in counterparts and by electronic or facsimile signature, each of which shall be deemed an original.

15. CLIENT COOPERATION

The Insured agrees to cooperate with the Adjuster, to provide truthful statements, to execute authorizations required to obtain records and to make available relevant documents, proofs of loss, and to appear for examinations under oath if requested by the insurer. Failure to cooperate may relieve the Adjuster of further obligations under this Agreement.

16. SPECIAL INSTRUCTIONS

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