AG ClaimsWorks – Shingle Identification Report

Report Reference

AGCW Report ID * Auto-generated. Format: AGCW-2026-0001 Report Date * Date this report was prepared

Client Information

Client Name * Full legal name of the requesting client Company Company or organization name, if applicable Email * Phone

Contractor Information

Contractor Company * Primary Contact Email Phone Mailing Address City / State / ZIP License Number (if applicable)

Property Information

Property Address * City / State / ZIP * Roof Type Primary roofing material on the structure

Insurance Claim Information

Insurance Carrier * Claim Number * The insurance carrier's assigned claim or file number Policyholder Name May differ from client name Date of Loss Date the loss or damage event occurred Adjuster Name Adjuster Contact Claim Notes (reference only)

Sample Information

Select all sample types provided and describe their condition.

Physical Shingle Sample Photographs Manufacturer Documentation

Sample Condition: Intact Weathered Fragmented

Number of Samples Submitted Sample Received Date

Identification Findings

Identified Manufacturer * e.g., CertainTeed, GAF, Owens Corning, Tamko, Atlas Identified Product Line * e.g., Landmark, Timberline HDZ, Duration, Heritage Shingle Style / Type e.g., Architectural, 3-Tab, Designer Color Identified or approximate color name Weight (per square)

Length Width Exposure

Production Status: In Production Discontinued Limited / Region-Specific Unable to Confirm

Known Production Window Approximate years the product was manufactured

Identification Result

Positive Identification Confirmed Identification Inconclusive

Identification Notes

Repair & Availability Statement

Edit this statement to reflect specific findings for this report.

Comparable / Replacement Products

List any known comparable or replacement products, if applicable.

Product Name Manufacturer Notes

Photo Evidence / Sample Images

Upload photos of the submitted sample. Images are representative of the submitted sample only.

+ Click to upload photos JPG, PNG, or WEBP. Max 5 MB each.

Photo Description / Notes Photo Description / Notes

Identification Methodology

Select all methods used during the identification process.

Visual Inspection Dimensional Measurement Manufacturer Database Research Physical Comparison Documentation Review

Additional Methodology Notes

Disclaimer

This report is provided for product identification and availability research only. AG ClaimsWorks is not acting as a public insurance adjuster, engineer, contractor, or legal advisor.

No opinions are expressed regarding damage causation, coverage, pricing, scope of repair, code compliance, or insurance policy interpretation.

This report may be used as supporting reference material only and is not an insurance estimate, engineering report, or coverage determination.

Client Acknowledgment

Client Signature (typed) * Type your full legal name as your electronic signature Date *

I acknowledge and agree to the scope and disclaimer above.

Shingle Identification & Product Availability Report

Missing Required Fields

Report Reference

Client Information

Contractor Information

Property Information

Insurance Claim Information

Sample Information

Identification Findings

Identification Result

Repair & Availability Statement

Comparable / Replacement Products

Photo Evidence / Sample Images

Identification Methodology

Disclaimer

Client Acknowledgment

Missing Required Fields

Report Reference

Client Information

Contractor Information

Property Information

Insurance Claim Information

Sample Information

Identification Findings

Identification Result

Repair & Availability Statement

Comparable / Replacement Products

Photo Evidence / Sample Images

Identification Methodology

Disclaimer

Client Acknowledgment

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