Certificate of Satisfaction 290 Heritage Ave., Ste 1 Portsmouth, NH 03801 Office 603-430-7701 | Fax: 603-373-6214Property Owner Name* First Last Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Property Owner PhoneProperty Owner Email* Insurance Company Service Completed*MitigationContentReconstructionInsurcomm Rep*Select Insurcomm RepBrian CurrierBrian VisoskyConnor RobbinsDennis CoteDerek GilbertDoug IndelicatoGlenn PaffordGreg NyeIvan GravelyJack KelleyJack SpoonerJamie CliffordJeff McLeanJenny WisemanJoe DeMarcoJohn MeyerJordan StolleJosh CarrierKyle DudleyMike PikeNick PfennigwerthPeter CarlbergRich MurphyRob ScoulerRon BoisvertRon VasseurRyan TheilScott MassaroShawn HysetteStu ThorneTabitha WilsonTim CarrTim DrummeyTim LeeTom HealyTrevor AbbottTom StevensDate* MM slash DD slash YYYY Property Owner Signature*By signing, customer acknowledges the ______________ has been completed by Insurcomm, Inc. to customer’s satisfaction.Customer Service and Qualify Control FormWas the office staff courteous, polite and helpful? Yes No Was the Project Mgr. that surveyed your job prompt, courteous & polite? Yes No Was the productions staff neat, courteous, knowledgeable & professional? Yes No Did Insurcomm, Inc. meet your expectations on this job? Yes No Did Insurcomm, Inc. communicate clearly during the job completion process? Yes No May we use you for a reference? Yes No Will you be using Insurcomm, Inc. for the rebuild process? Yes No May we use your first name and your comments on our website? Yes No What were your overall impressions of how Insurcomm, Inc assisted you during this time?CommentsThank you for your feedback. Insurcomm, Inc. strives to be the best restoration service company by consistently monitoring our performance. We appreciate your patronage and look forward to working for you again.PhoneThis field is for validation purposes and should be left unchanged. Δ
