Electrical Make Safe Form - Emergency Electrical

Electrical Make Safe

Claim Details

Field Assessor

Property Address

Street Address Address Line 2 City State / Province / Region

Date of Inspection:

Date

Time

Claim Number

PO#

Name/s of parties present

Instructions:

Eg: requested to attend site to perform a Make Safe to…

Work Performed:

Areas of Concern

Any previous issues or repairs present?

Any damage to electrical caused by claimed event?

Claimable Damage Repairs Required:

Are there any wear and tear (maintenance) related issues relevant to the claimed event?

Wear and Tear Repairs required:

Were any wear and tear issues present which are not relevant to claimed damage?

Wear and Tear repairs (not related to the claimed damage) required:

Overall Conclusion:

Post Image

Accepted file types: jpg, jpeg, png, gif.

Electrical Report Disclaimer:

This electrical report is limited to a non-invasive inspection and only to areas that are readily accessible to the representative. Where safe or reasonable access to the property is not permitted, the report will be limited to what is deemed safe to the representative at the time of inspection.

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