Public Adjuster/Business Entity] [Address and Suite Number] [City, State, Zip code]Adjuster Contract • March 3rd, 2021
This Public Adjuster Contract (hereafter referred to as "Agreement") is entered into between (full name of the insured), Insured(s) ("Insured"), living at (street address/town or municipality/zip) insured by (insurance company name) (policy number) and (full name individual public adjuster and license number) employed by (public adjuster business entity name and license number) ("Public Adjuster"), doing business at (permanent home state business address) with a business phone number of (business phone number) for the following described services relating to (specify type of loss/damage) caused by (cause) which occurred on (date) at approximately (time a.m./p.m.) at (street address/town or municipality/zip). Pursuant to the following terms and conditions, the parties agree to the following:
