Preliminary Form 2025V2

Preliminary
Company Name*
Company Email
Service Address*
Number of Impacts*

Point(s) of Impact
- Point of Impact*
- Impacted:*
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 1*
- Close Up View*
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View*
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Point of Impact
- Impacted:
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 2
- Close Up View
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Point of Impact
- Impacted:
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 3
- Close Up View
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Point of Impact
- Impacted:
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 4
- Close Up View
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Point of Impact
- Impacted:
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 5
- Close Up View
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Point of Impact
- Impacted:
  
  Right FrontRight RearLeft FrontLeft RearEntire StructureOther
- ***If you have not already, please obtain written pre-approval from the insurance carrier for the estimated amount of this claim, or contact GIB immediately.
- Description of Impact 6
- Close Up View
  
  These photos should be close enough to see the fine details of the damage. You should be able to clearly see the damage to the structure. Minimum of 4, maximum of 6 photos.
  Cancelof
- Far Away View
  
  These photos should be far enough away to see the entire structure. You should be able to see where you are on the property. Minimum of 4, maximum of 6 photos.
  Cancelof
- Tree Material Pitch
  
  Cancelof
- Point of Failure
  
  Cancelof
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof
- Do you need to list an additional tree for this impact?
  
  YesNo
- Tree Type
- Tree Type - List Other
- Tree Diameter
- Tree Diameter Photo
  
  Cancelof

Preliminary

Point(s) of Impact

Hazards & Barriers

Entry & Exit