KMK Adjuster Ladder Assist Request Form

Please fill out all sections and select submit.


Adjuster's Information

Please enter your contact information along with the Insurance Carrier's Name you are working for below.

These information will not be shared with anyone.

Loss Location Information

Please fill out the information about the Loss below.

Dwelling Type:

Do you need the roof measured?

Service Requested

Special instructions such as:
Aerial view or measurements needed; Xm8/drag and drop $10 requested; Roof other than comp; Three story ladder needs; Interior damage assist or leak detection


By clicking "Submit" below, you are agreeing that you have read and understand the Terms & Conditions listed below , from KMK



Please read the following terms and conditions of use before using this website. The term "KMK" refers to KMK Residential Restorations Inc., the owner of this website. The term "you" or "your" will refer to the user of this website.


By using this website you are agreeing to the following terms and agreement. If you do not agree to these terms and conditions, please do not use this site.


You, the user agree to any and all modifications, alterations and/or updates of these Terms of Use. Any revisions will become effective upon being posted on this website. Please read the Terms of Use section upon entering each time.


The content, organization, logo and trade name used in this site are applicable to trademarks and other proprietary rights, (including but not limited to intellectual property). Permission is granted to electronically copy and print hard copies of portions of this site for the purpose of placing a service order only. Any other use is strictly prohibited.


Harassment in any manner on this site to include but not be limited to the following, obscene or abusive language, threatening or illegal content on forms or via emails, any misrepresentation (including impersonation) and/or vioKMKing the rights of any other party is prohibited and may constitute a criminal offense.


These terms and conditions, or any part of them may be terminated by KMK without notice at any time. Provisions pertaining to Tradmarks, disclaimer, indemnification and miscellaneous shall survive any termination.


You understand that it is your responsibility to ensure the information given on a service order is correct and true. We are not liable or responsible for any loss/expense incurred for errors made on service order forms.


You agree to indemnify and hold harmless, its owners and all employees or representatives from and against all losses, expenses and damages to include any attorney fees, resulting from any vioKMKion of these terms and conditions. This includes, any negligent or wrongful conduct by you or any other person who may access a service form, using your personal information.


By choosing to access this website, you do so at your own risk and on your own initiative and are responsible for compliance with all applicable local laws. These terms shall be governed by and construed in accordance with the laws of the State of Texas, without giving effect to any principles of conflicts of law. You agree that any action of law arising out of or reKMKing to these terms shall be filed only in the state or federal courts located in Collin County, Texas, and you hereby consent and submit to the personal jurisdiction of such courts for the purposes of litigation. By using this website, you hereby submit to the jurisdiction of such courts for such purposes and waive any and all objections as to jurisdiction or venue in such courts. If any provision of these terms shall be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from these terms and shall not affect the validity and enforceability of any remaining provisions.


This is the entire agreement in respect to use of this website.
Effective date of this agreement is 5/10/2010


What information do we collect?

We collect information from you when you fill out a service order.

When filling out a service order on our site, as appropriate, you may be asked to enter your: Your name, e-mail address, name of the company you work for, phone number and personal information about the property owner where the service is to be performed, such as their name, address, insurance carrier and claim number.

What do we use your information for?

Any of the information we collect from you may be used in one or more of the following ways:

. To improve customer service
(your information helps us to more effectively respond to your customer service requests and support needs)

. To process your service order
Your information, whether public or private, will not be sold, exchanged, transferred, or given to any other company for any reason whatsoever, without your consent, other than for the express purpose of processing your service request.

. To send periodic emails
The email address you provide for order processing, will only be used to send you information and updates pertaining to your order.

How do we protect your information?

We implement a variety of security measures to maintain the safety of your personal information when you place an order

We offer the use of a secure server. All supplied sensitive information is transmitted via Secure Socket Layer (SSL) technology and then encrypted into our Database to be only accessed by those authorized with special access rights to our systems, and are required to keep the information confidential.

After a transaction, the private information you provided (names, addresses, company information, etc.) will be kept on file for more than 60 days in order to have quality control checks performed on our teams service and for our company record keeping.

Do we use cookies?

We do not use cookies.

Do we disclose any information to outside parties?

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.

Online Privacy Policy

This online privacy policy applies to information collected through our website and/or when placing a service order including any additional information that may be needed offline from you to complete your order.

Terms of Use

Please also visit our Terms of Use section establishing the use, disclaimers, and limitations of liability governing the use of our website at

Your Consent

By using our site, you consent to our websites privacy policy.

Changes to our Privacy Policy

If we decide to change our privacy policy, we will update the Privacy Policy modification date below.

This policy was last modified on 5/10/2010

Contacting Us

If there are any questions regarding this privacy policy you may contact us using the information below.

Web Address :

Email :

Office : 847-752-4022

GIVE US A CALL: (847) 752-4022
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If you have an insurance claim - don't hesitate and call us direct! Roofing Contractors Libertyville, Libertyville Roofing Company, Lake County Roofing Contractors

Our Siding and Roofing Contractors are available for the cities of (but not limited to): Waukegan, Vernon Hills, Libertyville, Warren, Avon, North Chicago, Gurnee, Round Lake Beach, Deerfield, Lake Zurich, Lindenhurst, Barrington, Beach Park, Crystal Lake, Wauconda, Prairie Crossing, Fox Lake, Antioch, Island Lake, Long Grove, Hastings, Winthrop Harbor, Park City, Highwood, Lake villa, Highland Park, Lake Forest, Round Lake Heights, Zion, Round Lake Park, Round Lake, Fox River Grov, Wheeling, Northbrook, Green Oaks, Kildeer, Lakemoor, Bannockburn, Third Lake, Tower Lakes, Port Barrington, Mettawa, Old Mill Creek, Indian Creek, Old Mill Creek, Volo and Gages Lake.

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468 Park Ave Lake villa 60046
33485 Mill Rd Grayslake, IL 60030