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CONTACT US

Phone/Fax

Phone: (800) 516-6978

Fax: 207-226-5718

Email:

Tom Nowakowski

tom@actioncatteam.com

Charles Carter

charles@actioncatteam.com

Resumes to:

tom@actioncatteam.com

ON-LINE INFO. SHEET -SCROLL DOWN THEN SUBMIT

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First Name:

Middle Name:

Last Name:

Referred to A.C.T. by?:

Address:

City:

State:

Zip:

E-Mail Address:

Cell#:

Hm#:

Florida Adj. Lic. #:                Type:
Issued Date:                    Expires:

Other Adj. Licenses Held:
(State, Issued Date, Date Expires)

Xactnet Address:

Languages Spoken:

Have you ever worked for FL Citizen's before:

Are you currently on any other FL Citizen's Vendors Roster?

Last 4 #'s of SSN:

List last 5 Employers with dates of employment.  (None will be contacted)

Indicate Years of Experience: (MUST MATCH RESUME')

# Years H.O. Exp:

# Years Comm. Exp:

# Years Mobile Home Exp:

# Years Sinkhole Exp:

# Years Quality Review Exp:

# Years LDCU Exp:

# Years NFIP Exp:

# Years Auto/Boat Exp:

# Years Liability Exp:

# Years Heavy Equipment Exp:

Type of Claims You prefer to handle: (Cat or Daily)

Estimating Programs Used:

Do you have an RV you use?

Do you work as a team? ie Husband/Wife, 1 Scope/1 Write:

Would you work inside examiners position?

Do you have claim management experience?         
Explain-

PLEASE SUBMIT THIS FORM AND THE SEND YOUR CURRENT RESUME' TO: tom@actioncatteam.com