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Total Loss Claim Settlement Retainer
Appraisal Engine Inc.
11205 ALPHARETTA HWY
Ste H4
Roswell, GA 30076
678-805-4066
connect@appraisalengine.com
Agreement Date
MM slash DD slash YYYY
Name
First
Incident Date
MM slash DD slash YYYY
VIN#
Expert's Obligations: Expert shall have the following obligations with respect to the Incident:
(only checked boxes apply)
To appraise the lost resale value, also known as the Diminished Value or "DV", of the Vehicle as a consequence of the Incident;
To negotiate, pursuant to any relevant first- or third-party insurance appraisal clause, the extent of any DV incurred by the Vehicle as a consequence of the Incident;
To appraise the Vehicle's fair market value at the moment immediately preceding the incident, also known as the "Actual Cash Value" value;
To negotiate, pursuant to any relevant first- or third-party insurance appraisal clause, the extent of the "Actual Cash Value" or "Total Loss" as a consequence of the Incident;and, to the extent Expert in its professional opinion believes that such negotiation has reached its limit, to memorialize the outcome of such negotiation in a written "Memorandum of Negotiation" or “Settlement Memorandum” , and to provide a copy of said Memorandum to Client, insurer, or both.
Expert Fee
Additional Terms
Card Number
Expiration Month
Expiration Year
Security Code
Billing Zip Code
Signature
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