Salvage Listing Form - Barga Insurance Salvage
Please Fill Out ALL Applicable Information.
Adjuster's Contact Info:
Adjuster's Name
*
First Name
Last Name
Independent Adjusting Firm and Mailing Address
File Number
Insurance Company and Mailing Address
*
Insurance Co Claim Number
*
Adjuster's Phone Number
*
-
Area Code
Phone Number
Adjuster's E-mail Address
*
Item Description and Location:
Item to be Listed
*
ACV of Item Posted
Year/Make/Model
Serial Number
Odometer/Hours
Options and Features that will Facilitate the Sale of the Item
*
Damage Description in as Much Detail as Possible
*
Omissions and/or Additions to the Salvage that May or May Not be Seen in the Photographs Posted
*
A lien check should be conducted (all equipment and vehicles). Do you wish us to conduct a lien check on your behalf. (charge of $20)
*
Yes
No
Is the Salvage Item Located with the Insured?
*
Yes
No
Location of Salvage and Contact Information
*
Contact Info for the Insured
*
Is the Salvage Item Accruing Storage Charges at This Time?
*
Yes
No
Once Sale is Finalized do you Want Barga.ca to Pay the Storage Charges on Your Behalf
*
Yes
No
Bid Requirements
*PLEASE NOTE: If no reserve bid is chosen, you are authorizing Barga Insurance Salvage to sell to the highest bidder.
Reserve Bid
*
Yes
No
Amount of Reserve Bid
Additional Comments
Upload Salvage Photos
Upload a File
Cancel
of
Upload Damage Estimate and/or Any Other Pertinent Documents
Upload a File
Cancel
of
Submit
Print Form
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