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Bid Information form
Please complete the following information.
What kind of bid are we proving?
Intact Recovered theft    
Partial Loss    
Total Loss  
Can this vehicle be sold with a clear title?   Yes    No
Is this vehicle drivable?   Yes    No
Does the vehicle have engine damage?   Yes    No
Vehicle Identification
Claim Number   
Date of Loss    (Format: MM/DD/YYYY)
Owners Name   
Veh. ID #   
License Plate #   
Location of Vehicle
Location notes: (if necessary)
Damage Description:
Value Information
Actual Cash Value   
Kelly Blue Book   
Your Bid Amount   
All bids are based on an accurate damage description. The bid is valid for 60 days and a clear, transferable title must be received within this time period. We are not responsible for any previous liens on the vehicle. The tow is included but does not reflect any additional recovery fees. The bid does not include any past due registration fees or state charges. Please allow 24 hours on all bids submitted on this web-site Tell us how to get in touch with you:
Insurance Name
Adjuster Name
Please contact me for additional circumstances with this claim.