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Contractor statement of damage

This form is for contractors to submit detailed information about missed damaged or sub-standard repairs.

Building details

Classifications can be found at
Tick both boxes if relevant.
Please summarise the extent of missed damage or sub-standard repairs and why you believe this damage is earthquake related.

By submitting this form you confirm you are a current licenced building practitioner, registered building surveyor, registered engineer or other suitably qualified expert and have inspected the property yourself.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
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