Truck Submission

Home > Sell your Salvage > Truck Submission
 
Your Name: Your Co. Name:
. . . .
Phone Number: Insured:
. . . .
Fax #: Your
Policy/Claim #:
. . . .
Email
Address:		 Date of Loss:
Date Format: MM/DD/YYYY    
. . . .
Insurance Co. or Salvage Seller: *
. .
Other Ins Co. or Salvage Seller: *
. . .
Number of days salvage will be displayed on the site.  Select from the drop down list 1 to 30 representing the number of days the salvage will remain on BTS. Note: 30 Day Max Unless Extended
.
* If your insurance company or the insurance company you are representing is NOT in the
 "Insurance Co" drop down list, select "Other" from the list and type the name of the
 insurance company in the "Other Ins Co" text box.
 
Billing Information *
If the submission is to be billed directly to an Insurance Company,
 we must have the following information.
 
Insurance Company:  
. .
Examiner's Name:
. .
Examiner's Policy / Claim Number:
. .
Fax Number:
. .
*All other billing will be to the individual or company submitting the salvage.
Location of Salvage
 City / State / Phone Number
Actual Cash Value of Vehicle $ NOT
Stated Limits
VERY Important
 
Title Type Salvage Title   Good Title   Non-Rebuildable   Not Applicable 
Year, Make & Model
Engine
Make 		Engine
Model		 Engine
HP
Full Vehicle Identification Number
Please Check Tenth Digit Against Model Year
Vehicle Mileage Hub Mileage
Cab Type
Sleeper
Type		 Sleeper
Roof		 Sleeper
Inches
Rear Axle Axle
Model		 Axle
Ratio
Transmission
Make		 Transmission
Model
Suspension
Fuel Tank Size Fuel
Tank
Type
Aluminum
Steel
# of tanks
1
2
Fifth Wheel Make Fifth Wheel
Type
 
Wheel Size Type Made Of
Tires

 Please Indicate
 Any
Damaged Tires

*Denotes
percentage of
tread left
on tire!		 Left
Front		 Damaged  Right
Front		 Damaged 
Recap  Recap
LRFO Damaged  RRFO Damaged 
Recap  Recap 
LRFI Damaged  RRFI Damaged 
Recap  Recap
LRRO Damaged  RRRO Damaged 
Recap  Recap 
LRRI Damaged  RRRI Damaged 
Recap  Recap 
 
Please give as much info about
damage as possible.  This is VERY important. The more info, the higher the bids!		 Example:Rollover. Hood, Cab, Sleeper Damaged.   Especially engine, transmission and frame damage!



 


 
 


Home  |  What We Do  |  Salvage for Bid  |  Sell your Salvage  |  About Us  |  Contact Us  |  Site Map

© 2002 Heavy Equipment claims of Florida, Inc
info@heavyequipmentclaims.com