Insured: Smith Claim #: 2020-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): Front Left Elevation

Comments:

Date Taken: 8/21/2020

Position(s): Back Right Elevation

Comments:

1
Insured: Smith Claim #: 2021-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): Back Left Elevation

Comments:

Date Taken: 8/21/2020

Position(s): Back Left Garage Elevation

Comments:

2
Insured: Smith Claim #: 2021-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): North Slope

Comments: Single layer of laminate

shingles including drip edge.

Date Taken: 8/21/2020

Position(s): North Slope

Comments: Pitch gauge photo.

3
Insured: Smith Claim #: 2021-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): North Slope Eastern

Quarter

Comments: Test box indicates no hail

damage.

Date Taken: 8/21/2020

Position(s): North Slope Eastern

Quarter

Comments: Image includes borders of

test box showing no present hail
damage.

4
Insured: Smith Claim #: 2021-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): South Slope Western

Quarter

Comments: Test Box indicates one

present hail hit.

Date Taken: 8/21/2020

Position(s): South Slope Western

Quarter

Comments: Additional hail hit found

outside of initial test box.

5
Insured: Smith Claim #: 2021-0122 File #: 875-5567-45651

Location of Loss: 1234 Maple St.

Castlewood SD, 57223 Policy #: F 23492 Adjuster: Carter Larson

Date Taken: 8/21/2020

Position(s): Southern Slope Western

Quarter

Comments: Image includes another

evident hail hit on south facing slope.

Date Taken: 8/21/2020

Position(s): Back Left Elevation AC

Unit

Comments: AC unit shows evident hail

damage on south facing side of
property.

6
 Xactimate Sketch

Date Created: 7/21/20

Software Used: Xactimate Plus

Software Version: X8-12.03.1

Dwelling Information:

Sq Ft: 2038 Square feet

Number of Exposures: 6

Number of Gables: 3

Type of Roofing: Shingles

Age of Dwelling: Built in 2007

7
 VAIS Inc, dba Dakota Claims Service of Watertown, Huron, & Aberdeen

___________________________________________________________

P.O Box 203, 414 10th St NW

Watertown SD 57201

Phone: (605)-886-2318

Fax: (888)-202-0648

Email: carterlarson@vais.com

2020-08-03-0122

Dwelling

Roof – South Exposure

Description Quantity Price Tax ACV

1. Replace roofing repair – 1.00 EA $510.73 12.90 523.63

Minimum charge - cover all
labor and materials for (2)
shingles S and E Exposures

Totals: Roof – South and East Exposures 12.90 $523.63

South Elevation
Description Quantity Price Tax ACV

2. Replace combing on 1.00 EA $150.00 $3.06 $153.06

AC Unit/ Replace Fins/
Add trip charge

Totals: South Elevation $3.06 $153.06

Totals: Dwelling $15.96 $676.69

8
 VAIS Inc, dba Dakota Claims Service of Watertown, Huron, & Aberdeen

___________________________________________________________

P.O Box 203, 414 10th St NW

Watertown SD 57201

Phone: (605)-886-2318

Fax: (888)-202-0648

Email: carterlarson@vais.com

Insured: Smith, Janet

Property: 1234 Maple St. Castlewood SD, 57223

Company: Northwest Mutual

Estimator: Carter Larson

Position: General Adjuster
Company: Dakota Claims Service
Business: VAIS INC.

Date Contacted:7/13/2020
Date of Loss: 7/11/2020
Date Inspected: 7/19/2020

Policy #: F 64540
Claim #: 5545-20

9
10