Insured: John Smith Home: (555) Property: 1234 Avenue D Wapakoneta, OH 45895

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5 1 Insured: John Smith Home: (555) Property: 1234 Avenue D Wapakoneta, OH Claim Rep.: CSI Representative John Smith Estimator: CSI Representative John Smith Reference: Business: (456) Company: Business: Claim Number: Policy Number: Type of Loss: Wind Damage Date Contacted: 7/10/2012 Date of Loss: 6/29/2012 Date Received: 7/10/2012 Date Inspected: 7/16/2012 Date Entered: 7/19/2012 Price List: Estimate: OHPO7X_JUL12 Restoration/Service/Remodel M&G-TRIPLETT

6 2 M&G-TRIPLETT Loc 1 Bldg 1 Roof Surface Area Total Perimeter Length Total Hip Length Number of Squares Total Ridge Length DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV ADDITIONAL LAYERS OF SHINGLES MUST BE VERIFIED TO BE CONSIDERED FOR A SUPPLEMENT, 1. Remove Laminated - comp. shingle SQ , <0.00> 1, rfg. - w/ felt 2. Laminated - comp. shingle rfg. - w/ SQ , <3,641.66> 3, felt 3. R&R Ridge cap - composition LF <272.54> shingles 4. Remove 3 tab - 20 yr. - composition 7.58 SQ <0.00> shingle roofing - incl. felt 5. 3 tab - 20 yr. - composition shingle 7.67 SQ , <806.96> roofing - incl. felt 6. Aluminum coating - without fiber 5, SF , <1,606.00> Drip edge LF <169.56> Remove Additional charge for high SQ (0.00) roof (2 stories or greater) 9. Additional charge for high roof ( SQ (0.00) stories or greater) 10. Roof vent - turtle type - Metal EA <173.89> Flashing - pipe jack 1.00 EA <10.45> Chimney flashing - average (32" x 2.00 EA <186.46> ") The items actually being flashed are two large roof ornamental pieces. Totals: Loc 1 Bldg 1 Roof 15, , , Loc 1 Front Elevation DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 13. Soffit, fascia & gutter - Minimum 1.00 EA (0.00) charge Allows for soffit and fascia. Totals: Loc 1 Front Elevation M&G-TRIPLETT /2/2013 Page: 2

7 3 SKETCH2 Main Level Loc 2 Bldg 1 Roof Surface Area Total Perimeter Length Number of Squares Total Ridge Length DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 14. Remove 3 tab - 25 yr SQ , <0.00> 1, composition shingle roofing - incl. felt tab - 25 yr. - composition shingle SQ , <4,110.20> 2, roofing - incl. felt 16. Remove Additional charge for SQ (0.00) high roof (2 stories or greater) 17. Additional charge for high roof ( SQ (0.00) stories or greater) 18. R&R Continuous ridge vent LF <125.71> aluminum 19. R&R Flashing - pipe jack 3.00 EA <31.34> Temporary Repair 1.00 EA (0.00) Mr. Triplett paid there maintenance man an hourly wage to repair the roof. Totals: Loc 2 Bldg 1 Roof 9, , , Loc 2 Right DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 21. R&R Gutter / downspout LF , <623.86> aluminum - 6" Totals: Loc 2 Right 1, Loc 2 Left DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 22. R&R Gutter / downspout LF <102.27> aluminum - 6" M&G-TRIPLETT /2/2013 Page: 3

8 4 CONTINUED - Loc 2 Left DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Totals: Loc 2 Left Loc 2 Back DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 23. Comb and straighten a/c condenser 1.00 EA (0.00) fins - with trip charge 24. Siding - Minimum charge 1.00 EA (0.00) Totals: Loc 2 Back Total: Main Level 10, , , Total: SKETCH2 10, , , Line Item Totals: M&G-TRIPLETT , , , Grand Total Areas: 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls and Ceiling 0.00 SF Floor 0.00 SY Flooring 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 0.00 LF Ceil. Perimeter 0.00 Floor Area 0.00 Total Area 0.00 Interior Wall Area 1, Exterior Wall Area 0.00 Exterior Perimeter of Walls 13, Surface Area Number of Squares Total Perimeter Length Total Ridge Length Total Hip Length M&G-TRIPLETT /2/2013 Page: 4

9 5 Coverage Item Total % ACV Total % Loc 1 Bldg 1 15, % 8, % Loc 2 Bldg 1 10, % 5, % Dwelling % % Other Structures % % Total 25, % 14, % M&G-TRIPLETT /2/2013 Page: 5

10 6 Summary for Loc 1 Bldg 1 Line Item Total 15, Material Sales 7.000% Replacement Cost Value $15, Less Non-recoverable Depreciation <7,105.62> Actual Cash Value $8, Less Coinsurance (4,607.72) Less Deductible (1,000.00) Net Claim $3, CSI Representative John Smith M&G-TRIPLETT /2/2013 Page: 6

11 7 Summary for Loc 2 Bldg 1 Line Item Total 10, Material Sales 7.000% Replacement Cost Value $10, Less Non-recoverable Depreciation <5,189.55> Actual Cash Value $5, Less Coinsurance (993.81) Less Deductible (1,000.00) Net Claim $3, CSI Representative John Smith M&G-TRIPLETT /2/2013 Page: 7

12 8 Recap by Room Estimate: M&G-TRIPLETT Loc 1 Bldg 1 Roof 15, % Coverage: Loc 1 Bldg % = 15, Loc 1 Front Elevation % Coverage: Loc 1 Bldg % = Area: SKETCH2 Area: Main Level Loc 2 Bldg 1 Roof 9, % Coverage: Loc 2 Bldg % = 9, Loc 2 Right 1, % Coverage: Loc 2 Bldg % = 1, Loc 2 Left % Coverage: Loc 2 Bldg % = Loc 2 Back % Coverage: Loc 2 Bldg % = Area Subtotal: Main Level 40.65% 10, Coverage: Loc 2 Bldg % = 10, Area Subtotal: SKETCH % 10, Coverage: Loc 2 Bldg % = 10, Subtotal of Areas 25, % Coverage: Loc 1 Bldg % = 15, Coverage: Loc 2 Bldg % = 10, Total 25, % M&G-TRIPLETT /2/2013 Page: 8

13 9 Recap by Category with Depreciation Items RCV Deprec. ACV GENERAL DEMOLITION 4, , Coverage: Loc 1 Bldg 55.17% = 2, Coverage: Loc 2 Bldg 44.83% = 1, HEAT, VENT & AIR CONDITIONING Coverage: Loc 2 Bldg % = ROOFING 20, , , Coverage: Loc 1 Bldg 64.18% = 12, Coverage: Loc 2 Bldg 35.82% = 7, SIDING Coverage: Loc 2 Bldg % = SOFFIT, FASCIA, & GUTTER 1, Coverage: Loc 1 Bldg 16.86% = Coverage: Loc 2 Bldg 83.14% = 1, Subtotal 25, , , Material Sales 7.000% Coverage: Loc 1 Bldg 57.39% = Coverage: Loc 2 Bldg 42.61% = Total 26, , , NOTICE: This is an estimate for repairs and a copy of this document does not constitute settlement of claim. The above figures may be subject to additional company review and approval. Your loss will be settled on an actual cash value basis and your policy may contain a replacement cost provision. If it contains such a provision, full cost of replacement can be considered if the property is actually replaced. You have the right to make further claim under this provision within 180 days after the loss. All policy terms and conditions apply to this claim. M&G-TRIPLETT /2/2013 Page: 9

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15 SKETCH1 - Main Level M&G-TRIPLETT /2/2013 Page: 1

16 SKETCH2 - Main Level M&G-TRIPLETT /2/2013 Page: 2

17 1 1 Loc 1 Risk Risk overview. 2 Loc 1 Pitch Guage 6:12 pitch. M&G-TRIPLETT /2/2013 Page: 1

18 2 3 Loc 1 Shingle Guage 4 Loc 1 Front Slope Slope overview. M&G-TRIPLETT /2/2013 Page: 2

19 3 5 Loc 1 Front Slope Overview of hail damage. 6 Loc 1 Front Slope View of a hail impact mark. M&G-TRIPLETT /2/2013 Page: 3

20 4 7 Loc 1 Front Slope View of a hail impact mark. 8 Loc 1 Front Slope View of a hail impact mark. M&G-TRIPLETT /2/2013 Page: 4

21 5 9 Loc 1 Front Slope View of a hail impact mark. 10 Loc 1 Right Slope Slope overview. M&G-TRIPLETT /2/2013 Page: 5

22 6 11 Loc 1 Right Slope View of hail damage to the roof coat. 12 Loc 1 Back Slope Slope overview. M&G-TRIPLETT /2/2013 Page: 6

23 7 13 Loc 1 Back Slope View of hail damage to the roof coat. 14 Loc 1 Back Slope View of hail damage to the roof coat. M&G-TRIPLETT /2/2013 Page: 7

24 8 15 Loc 1 Back Slope View of hail damage to the roof coat. 16 Loc 1 Back Slope View of hail damage to the roof coat. M&G-TRIPLETT /2/2013 Page: 8

25 9 17 Loc 1 Left Slope Slope overview. 18 Loc 1 Left Slope View of hail damage to the roof coat. M&G-TRIPLETT /2/2013 Page: 9

26 10 19 Loc 1 Left Slope View of hail damage to the roof coat. 20 Loc 1 Lower Roof View of wind damage. M&G-TRIPLETT /2/2013 Page: 10

27 11 21 Loc 1 Front Elev Elevation overview. 22 Loc 1 Front Elev View of wind damage to the soffit. M&G-TRIPLETT /2/2013 Page: 11

28 12 23 Loc 1 Front Elev View of damage to the fascia. 24 Loc 1 Left Elev Elevation overview. M&G-TRIPLETT /2/2013 Page: 12

29 13 25 Loc 1 Back Elevation Elevation overview. 26 Loc 1 Right Elev Elevation overview. M&G-TRIPLETT /2/2013 Page: 13

30 14 27 Loc 2 Risk Risk overview. 28 Loc 2 Shingle Guage 25 year shingle. M&G-TRIPLETT /2/2013 Page: 14

31 15 29 Loc 2 Pitch Guage 3:12 pitch. 30 Loc 2 Left Slope Slope overview. M&G-TRIPLETT /2/2013 Page: 15

32 16 31 Loc 2 Left Slope View of shingles that were temporarily installed to prevent further damage. 32 Loc 2 Left Slope View of shingles that were temporarily installed to prevent further damage. M&G-TRIPLETT /2/2013 Page: 16

33 17 33 Loc 2 Left Slope View of shingles that were temporarily installed to prevent further damage. 34 Loc 2 Left Slope View of shingles that were temporarily installed to prevent further damage. M&G-TRIPLETT /2/2013 Page: 17

34 18 35 Loc 2 Right Slope Slope overview. 36 Loc 2 Right Slope View of shingles that were temporarily installed to prevent further damage. M&G-TRIPLETT /2/2013 Page: 18

35 19 37 Loc 2 Right Slope View of shingles that were temporarily installed to prevent further damage. 38 Loc 2 Right Slope View of wind damage. M&G-TRIPLETT /2/2013 Page: 19

36 20 39 Loc 2 Right Slope View of wind damage. 40 Loc 2 Right Slope Overview of hail damage. M&G-TRIPLETT /2/2013 Page: 20

37 21 41 Loc 2 Right Slope View of a hail impact mark. 42 Loc 2 Right Slope View of a hail impact mark. M&G-TRIPLETT /2/2013 Page: 21

38 22 43 Loc 2 Right Slope View of a hail impact mark. 44 Loc 2 Right Elev Elevation overview. M&G-TRIPLETT /2/2013 Page: 22

39 23 45 Loc 2 Right Elev View of damage to the gutter. 46 Loc 2 Right Elev View of damage to the gutter. M&G-TRIPLETT /2/2013 Page: 23

40 24 47 Loc 2 Back Elevation Elevation overview. 48 Loc 2 Back Elevation View of damage to the downspout. M&G-TRIPLETT /2/2013 Page: 24

41 25 49 Loc 2 Left Elevation Elevation overview. 50 Loc 2 Left Elevation View of damage to the HVAC fins. M&G-TRIPLETT /2/2013 Page: 25

42 26 51 Loc 2 Left Elevation View of damage to the siding. M&G-TRIPLETT /2/2013 Page: 26

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