Fund Reallocation Form

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Fund Reallocation Form

Customer Name(s): __________________________________________________ Service Address: ____________________________________________________

Estimator/Planner: ___________________________________________________

Insurance Co. / Policy # (if applicable):__________________________________

Claim # (if applicable):________________________________________________

I/We have requested that _________________________________ leave existing flooring in the ____________________________________________ as is. I/We request that the funds allocated for the repair/replacement in the room/s noted be applied towards the following rooms/upgrades:

My/Our signatures on this form indicate my/our understanding that the flooring in _______________________________________ will remain as is and that all funds for this/these area/s has/have been reallocated to the rooms/upgrades listed above.

Approvals

Customer Name: ___________________________ Date: ___/___/____ Customer Name: ___________________________ Date: ___/___/____ Estimator/Planner: ___________________________ Date: ___/___/____