Join Our CAT RosterHome » Catastrophe Servicing » Join Our CAT Roster Please complete the following form to submit your Catastrophe Questionnaire. Provide responses that are as complete and accurate as possible to avoid approval delays.*Your approval will ultimately be subject to furnishing copies of current licenses and certifications.1 2 3 Your Contact InformationName*Your Email* Your Phone*Availability by Phone Select All Daytime Evening CellAddress Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code ExperienceDo you currently hold an adjusters license in your state of residency and/or any other states? YesWhich states?Are you currently certified by NFIP? YesAre you NFIP Authorized for the following?(select as many as apply) Select All Commercial Residential Mobile Home Residential Building Condo Large CommercialDate of last NFIP seminar attended Date Format: MM slash DD slash YYYY Has your adjuster's license or NFIP certification been revoked? YesPlease explain including any reinstatement.Do you currently carry E&O? YesWith Who?Do you currently carry Workers’ Comp? YesWith Who?Have you ever worked catastrophe under the SAP? Select All Yes for NC Yes for SCWith Who and When? Additional DetailsWhat type of estimating software do you utilize?Does your property expertise include marine such as pleasure watercraft or specialty situations such as piers, marinas, etc.? YesPlease ExplainAre you willing keep timesheets?While invoicing would be mostly fee schedule-based, would you be willing to keep timesheets, particularly as to all contacts or attempted contacts with policyholder/policyholder's representative and the client? YesWould you be willing to work on a per diem basis? YesName, address and phone number of relative who lives apart from you who will always know your current whereabouts:CommentsThis field is for validation purposes and should be left unchanged.