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Assign a Job

Welcome to the Allied/Nationwide Assign a Job Page!
Please complete the following form to send us an assignment. You will receive an Acknowledgement of Assignment Receipt within one business day by e-mail or fax indicating we have received your case.

Please provide the following contact information:
Name :
Title : 
Address :
City : 
State/Province :
Zip/Postal Code :
Phone :
Fax :
E-Mail :
 
Please provide the following claim information:
Claim Number :
Date of Loss :
 
Please provide the following information about the insured:
Name :
Address :
City : 
State/Province :
Zip/Postal Code :
Contact Phone :
Vehicle Year/ Make/Model :
VIN : 
Plate Number : 
Insured Vehicle Location : 
 
Please provide the following information about the claimant:
Name :
Address :
City : 
State/Province :
Zip/Postal Code :
Contact Phone :
Vehicle Year/ Make/Model :
VIN : 
Plate Number : 
Claimant Vehicle Location : 
 
Please describe what happened:
 
What would you like us to do (check all that apply):
Accident Reconstruction
Air Bag Failure
Animation
Brake/Steering/Suspension System Failure
Fire Cause & Origin
Headlamp On-Off
Ignition Lock Analysis
Low Velocity Impact (Full Report)
Low Velocity Impact (Short Report)
Photo Only
   Photo Accident Scene
   Photo Claimant Vehicle
   Photo Insured Vehicle
Seatbelt Evaluation
Stolen/Recovered Vehicle
Throttle System Failure
Tire Failure Analysis
Other (Please specify below)
 
Is there anything else we need to know:
 
Is a verbal report needed:
Yes No
 


Our 21 Day  Guarantee
If we do not get your assignment completed within 21 calendar days, then we cut your cost in half. That’s right, 50% off if we don’t get it done and back to you within 21 days!
Vision Statement
At VMAR we honor God by wholeheartedly upholding and demonstrating biblical principles in all of our relationships. We are specifically committed to delighting our clients by consistently delivering superior service and unparalleled performance in vehicle mechanical failure analysis and vehicle accident reconstruction. (2 Tim. 2:15)


 
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