American Freedom Insurance Company PHYSICAL DAMAGE INSPECTION/ MECHANICAL STATEMENT REPORT 559 W. Golf Rd. Arlington Heights IL 60005 Named Insured Policy No. Address Producer City State Zip VEHICLE INFORMATION Year Make/Model Doors VIN Color Odometer FOR PHYSICAL DAMAGE COVERAGE conduct a visual inspection of the vehicle and indicate on the illustration the areas where any damage exists such as dents holes chips scratches rust etc. Give special attention to bumpers windshields and condition...
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