Thunderbird Catastrophe Services, LLC.
P.O. Box 697
Rancho Cucamonga, CA 91729
Fax (909) 944-3412
Email catadj@thunderbirdcat.com 		 
 
Personal Information
Name : Address :
Home Phone: Mobile phone :
  Email Address:
 
Are you available to work west coast storms this winter?
  Yes
  No
 
Certifications & License
Are you California Earthquake Certified? Are you NFIP Certified?
 Yes   Date :   Yes  Date :  
 No  No
List any licenses issued
Type
State
License Number
Expiration Date
Issuer
 
Work Experience
Please indicate which claims you have experience with and for how many years. Would you be interested examining files in a cat office?
 Property Dwelling        
 Property Commercial   
 Mobile Home                
 General Liability           
 Flood                           
 Earthquake                 
 Yes
 No
 
Do you have experience examining files in a cat office?
 Yes   Years of experience  
 
List last 5 employers
 
Date Employer Name Employer Phone Number
 
Systems Capabilities
 
What estimating program do you use?
 MS/B IntegriClaim
 Simsol
 Xactimate
 Other 
 
Do you have a digital camera?
 Yes
 No
Have you ever done claim reporting on a website?
 Yes
 No
 
Do you have capability to do paperless files?
 Yes
 No
 Not Sure
 
Additional Comments
Thank you for your participation!