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Rutherford One Insurance Services LLC - Specializing in Homeowners, Dwelling, Property, Condo, Apartment and Renters Insurance for California
Latest News!

Rutherford One Insurance Services LLC is now a CARFAX authorized representative and now offers special pricing for a Full History CARFAX Report. Providing this service is just another layer of protection we can provide to our clients when making a decision to purchase a motor vehicle. Contact us for more details.

CARFAX

Now partnering with Hagerty "The Classic and Collector Car insurance Specialist"  

Hagerty Collector Car Insurance

Now licensed in Arizona AZ License #: 1013921



Now licensed in Nevada NV License #: 857071



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Property Loss Form...

 
Please use the form below to notify us of any loss or damage to your property insured through Rutherford Insurance Services. Please note that this form is for notification purposes only and does not constitute making an actual claim. One of our representatives will contact you shortly after receiving this notification.

Disclaimer:
I understand that this does not constitute an actual claim, but is rather a notification to my agent of an existing loss or claim, and may help expedite the claim process once I have filed.
    I have read and agree with the above
(Box must be checked before request can be sent)

Policy Holder Information
Please be sure to supply your phone number and email address so that we may contact you after receiving this notification.
Name Insured:  
Address:  
City:  
State:  
Zip Code:  
Work Phone Number:  
Home Phone Number:  
Email:  

Time and Description of Loss
Time:  
    A.M.   P.M.  
Date:  
Location of Property:  
Description of Loss:  

Authority Notification
Were the Police or Fire Deparment. Called?   Yes   No  
If Yes, Which Authority?  

Property Status
Is the Property Habitable?   Yes   No  
If No, where are you staying:
(Address and Telephone)
 

Report Information
Reported By:  
Title (if any):  
Date:  

Additional Comments
Please give any additional comments you feel appropriate for this Loss Notice.
   

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Contact Us Today
at 916-962-9909 or
Email
us for further information.

Rutherford One Insurance Services LLC
is licensed by the California Department
of Insurance, Lic# 0N06291.

Rutherford One Insurance Services LLC accepts VISA, MasterCard, Discover and AMEX credit cards
Rutherford One Insurance Services LLC accepts
these forms of payment for your convenience






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