Before You Start

This click-through questionnaire collects the information commonly needed for a commercial or General Property flood claim. The required document checklist is included near the beginning because those items are often needed before the file can be completed.

Privacy note: Your answers stay in your browser. FloodPath does not upload, store, or automatically email this form. When finished, choose Print / Save Signed PDF, save it, and send it to your adjuster.

Answer what you know.
If something does not apply, leave it blank or choose Not Applicable.
You can print/save the completed packet at the end.

Policy & Contact

Policyholder / Company Name

Policy Number

Claim Number

Date of Loss

Address of Loss Location

Mailing Address

Best Contact Number

Alternate Contact Number

Email Address

Agent Name / Phone / Email

Required Commercial Documentation Checklist

Notes about missing or attached documents

Ownership & Authority

Construction Date

Year of Purchase

Is this building owned by an individual?

If yes, individual owner name

Is this building owned by a Corporation, LLC, or other legal entity?

Legal entity name

Name recorded on Title/Deed to the building

List all persons authorized to sign legal documents and receive checks

Is the building or any portion leased?

Lease / tenant details

Property, Contents, Mortgages & Loans

Is there a mortgage on the building?

Building mortgage company / loan info

Do you own the contents in this building?

Is there a mortgage that covers the contents?

Contents mortgage company / loan info

Is there an SBA loan on the building or contents?

SBA loan details

Other Insurance & Prior Losses

Do you have other insurance that covers flood damage or sewer backup?

Carrier / Policy # / Building and Contents limits

Do you have other insurance for building and/or contents for perils other than flood?

Carrier / Policy # / Building and Contents limits

Have there been prior/previous flood losses at this property?

If yes, list month/year, claim amount, and whether repairs were made

Floodwater & Claim Details

Nearest body of water

Approximate distance from building

Date water entered building

Time water entered building

Date water exited building

Time water exited building

Exterior water height

Interior water height

Do you intend to use a General Contractor to make repairs?

General Contractor name / contact number

Are you requesting an Advance Payment toward your loss?

If advance not requested, explain why

Where would you like settlement/advance checks sent?

Did you receive a copy of the Flood Claims Handbook?

Additional comments

Signature

Printed Name

Title

Email, if available

Signature Date

Typed Signature

Review, Sign, Print / Save PDF

Review your answers below. Sign using typed signature or draw your signature, then click Print / Save Signed PDF.

Commercial Flood Field Questionnaire

Completed questionnaire for adjuster review.