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Licensed & Insured Public Adjusters

    This CONTRACT is entered into this day of
    20 by and between the “insured,” and Guard Your Claim, Inc.

    The insured hereby retains Guardian Adjusting Services of Florida, Inc. (hereinafter referred to as the firm) to advise and assist in the adjustment and negotiation of his/her insurance claim.

    Said loss occurred at the following location:

    Street City
    State Zip code
    Insurance Company Policy Number
    Type of Loss Date of Loss

    Guard Your Claim, Inc. will be paid contingent fee of the whole amount of the actual damage recovered by adjustment, litigation, or otherwise under the Policy after deductible. Client is responsible for any deductibles under the Policy. Guard Your Claim, Inc. does not receive the contingent fee from the client until the client receives monetary settlement from the insurer.

    The assignment created hereby is absolute and unconditional. The insured directs and agrees to have Guard Your Claim, Inc. named as a payee on all settlement drafts associated with the representation of this claim. In the event the insurer fails to issue a check made payable jointly to the Client and Guard Your Claim, Inc. the Client hereby grants Guard Your Claim, Inc. a lien on recovered proceeds received by the Client to the extent of the fee due to Guard Your Claim, Inc. pursuant to the terms of this agreement. In the event either party retains counsel to enforce this Agreement, the prevailing party shall be entitled to recover its court costs and reasonable attorney’s fees, including those of any appellate proceedings. This agreement shall be governed and construed in accordance with the laws of the State of Florida.

    Pursuant to s. 817.234, Florida Statues, any person who, with the intent to injure defraud or deceive any insurer or insured, prepares, presents or causes to be presented a proof of loss or estimate of cost or repair of damaged property in support of a claim under an insurance policy knowing that the proof of loss or estimate of claim or repairs contains any false, incomplete, or misleading information concerning any fact or thing material to the claim commits a felony of the third degree, punishable as provided in s. 775.082 or s. 775.803 or s. 775.084, Florida Statutes.

    The Client hereby acknowledges and agrees that this Agreement shall be construed as being executed by both parties hereto in the State of Florida. Each individual executing this Agreement on behalf of the Client represents and warrants that he/she is duly authorized to execute and deliver this Agreement. An insured or claimant can cancel a contract with a public adjuster without penalty or obligation within 3 business days after the date it was executed or within 3 business days after the date the insured or claimant notified the insurer of the claim, whichever is later. Notice of cancellation must be submitted in writing and sent by certified mail, return receipt requested, or other form of mailing which provides proof, to the public adjuster's address specified in the contract. However, during any state of emergency as declared by the Governor and for a period of 1 year after the date of loss, the insured or claimant will have (5) business days after the execution date to cancel a contract. The rights of either party hereunder may be assigned in whole or in part and the provisions hereof shall insure to the benefit of and binding upon the heirs, personal representative, beneficiaries, successors and assigns. Guard Your Claim, Inc. agrees not to accept any settlement or adjustment unless it is satisfactory to the Client.

    Re-Open Claims Non Emergency Claims Emergency Claims Supplement Claims Client/Insured/Policyholder Date
    Licensed Public Adjuster Date

    License No.

    Please Send Claim Payment Draft to Our Office
    814 Ponce De Leon Blvd, Suite 217
    Coral Gables, Florida. 33134
    Office: 305.946.9155 Fax: 305.489.5922

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