Risk Management Assistance Request
First Name
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Last Name
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Firm Name
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Current CRES Policy Number
Email Address
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Best Contact Phone Number
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Brief description of your question or issue
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Property Address, if applicable
Have you received anything in writing regarding this issue? (e.g. demand letter, subpoena, lawsuit) If YES, please submit a copy to: GGB.LV2.CRES.RiskMgt@ajg.com
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Yes
No
Do you know if any parties in this issue are involved in a claim or lawsuit? If YES, please provide some detail.
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Yes
No
If yes to previous question, please provide detail here: