AG ClaimsWorks

Client Information

Property Information

Sample Information

Sample Type (check all that apply):

☐ Physical Shingle Sample (Client-Provided)
☐ Photographs (Client-Provided)
☐ Manufacturer Documentation (Client-Provided)

Sample Condition: ☐ Intact ☐ Weathered ☐ Fragmented

Number of Samples Submitted: __________

Scope of Services

AG ClaimsWorks provides product identification and availability research only. Services are limited to the following:

• Visual examination
• Dimensional measurement (length, width, exposure, thickness where possible)
• Pattern, mat, and granule comparison
• Manufacturer and product line identification (when possible)
• Research into production status (in production / discontinued / limited availability)
• Review of manufacturer literature, archives, and reference materials
• Comparative analysis against known products

No opinions are offered beyond product identification and availability research.

Expressly Excluded Services

• Insurance claim handling or negotiation
• Public adjusting services
• Coverage interpretation
• Pricing, estimating, or scope of repair opinions
• Cause-of-loss determinations (hail, wind, wear, etc.)
• Code compliance opinions
• Structural or engineering opinions
• Safety, performance, or service-life conclusions

Identification Findings

Identified Manufacturer: _______________________________

Identified Product Line: _______________________________

Shingle Style / Type: _________________________________

Measured Dimensions:

• Length: __________
• Width: __________
• Exposure: ________

Production Status (best available information):

☐ Currently in Production
☐ Discontinued
☐ Limited / Region-Specific
☐ Unable to Confirm with Available Data

Known Production Window (if available):

Comparative Products (If Applicable)

The following products may be visually or dimensionally similar based on available reference data. This does not imply interchangeability or replacement suitability.

• _________________________________

• _________________________________

Limitations

• Identification is based solely on materials submitted and reference data available at the time of analysis.
• Roofing products may vary by region, manufacturing run, and time period.
• Manufacturer records may be incomplete or unavailable for older or discontinued products.
• Absence of confirmation does not imply non-existence of a product.

Client Acknowledgment

• The report is limited to product identification research
• No claim advocacy or insurance interpretation is provided
• AG ClaimsWorks assumes no responsibility for claim outcomes or coverage decisions
• Use of this report does not create an adjuster, engineer, or attorney-client relationship

Client Signature: ____________________________

Date: ___________________