SAMPLE

Proof of Repair Inspection Report

Insurance Carrier Verification — Prior Claim Repair Documentation
Vcita Home Inspection & Service LLC | FL License #HI-14823
Property Address
1234 Palm Harbor Drive, Tampa, FL 33615
Homeowner
John & Maria Rodriguez
Inspection Date
March 12, 2026
Report #
POR-2026-00047
Prior Claim Reference

This inspection was conducted to verify that damage from a prior insurance claim has been properly repaired, as required by the new insurance carrier for underwriting purposes.

Date of Loss
September 28, 2024
Peril / Cause
Hurricane (Wind & Water)
Claim Number
WC-2024-FL-884291
Prior Carrier
Citizens Property Insurance Corp.
Claim Amount Paid
$38,750.00
New Carrier
Heritage Insurance Holdings
Claim Summary
Hurricane-related wind and water damage to roof system, soffit/fascia, pool screen enclosure, and interior ceilings. Claim paid September 2024 by Citizens Property Insurance Corporation. Repairs completed between October 2024 and January 2025 by licensed contractors.
Repair Verification — Component Detail

Each damaged component from the prior claim was inspected to verify the repair was completed, the current condition meets acceptable standards, and supporting documentation (permits, contractor records) is available.

ComponentOriginal DamageRepair PerformedCurrent ConditionVerified
Roof System (Shingle) ~30% shingle loss on south & east slopes; ridge cap displaced; underlayment exposed Full tear-off and re-roof — GAF Timberline HDZ architectural shingles, new ridge venting, ice & water shield at eaves Excellent — no defects, proper installation observed ✓ Verified
Chimney Flashing Step and counter flashing lifted; potential water intrusion point Removed and re-installed with new lead step flashing and sealed counter flashing Good — no gaps, properly sealed ✓ Verified
Soffit & Fascia Two soffit panels detached on east elevation; fascia board cracked in two locations Replaced damaged soffit panels (vinyl) and cracked fascia boards; repainted to match Good — secure attachment, no visible damage ✓ Verified
Pool Screen Enclosure Completely destroyed — all panels torn, aluminum frame bent Full replacement — new aluminum frame with 18/14 mesh screen, 120 mph wind-rated Excellent — new construction, properly anchored ✓ Verified
Interior Ceilings Water staining in master bedroom (~4×3 ft) and hallway (~2×2 ft) from roof breach Drywall replaced, skim-coated, primed and painted; no mold detected after remediation test Good — smooth finish, no staining or moisture ✓ Verified
Attic Insulation Blown-in insulation saturated in ~80 sq ft area from water intrusion Saturated insulation removed; area dried and treated; new R-30 blown-in cellulose installed Good — dry, uniform coverage, no moisture detected ✓ Verified
Gutter System Gutters pulled away from fascia on south side; downspout displaced Re-secured gutters with new concealed hangers; replaced damaged downspout section Good — proper slope, secure attachment ✓ Verified
Contractor & Permit Documentation
ComponentContractorPermit #Date Completed
Roof SystemABC Roofing Inc. — CCC#1330847BP-2024-08421November 15, 2024
Chimney FlashingABC Roofing Inc. — CCC#1330847Included in BP-2024-08421November 15, 2024
Soffit/FasciaABC Roofing Inc. — CCC#1330847Included in BP-2024-08421November 20, 2024
Pool Screen EnclosureSunshine Screen Enclosures — SCC#131272BP-2024-09103January 8, 2025
Interior Drywall/PaintPremium Painting & Drywall LLCN/A (cosmetic)December 5, 2024
Attic InsulationABC Roofing Inc. — CCC#1330847Included in BP-2024-08421November 15, 2024
Gutter SystemABC Roofing Inc. — CCC#1330847Included in BP-2024-08421November 18, 2024
Photo Documentation

Before and after photographs documenting the condition of each repaired component.

📷 BEFORE — Roof Shingle Loss (South Slope)
📷 AFTER — New Roof Installation Complete
📷 BEFORE — Screen Enclosure Destroyed
📷 AFTER — New Screen Enclosure Installed
📷 BEFORE — Interior Ceiling Water Damage
📷 AFTER — Ceiling Repaired & Painted
📷 BEFORE — Soffit Panels Detached
📷 AFTER — New Soffit Panels Installed
Verification Summary
7 / 7
Components Verified — All Repairs Complete

All seven components identified in the prior claim have been inspected and verified as properly repaired. Repairs were performed by licensed contractors with applicable permits pulled and finalized. No outstanding deficiencies were identified related to the prior claim.

Inspector Attestation
Certification Statement
I, the undersigned licensed inspector, certify that I have personally inspected the above-referenced property and that this report documents the current observed visible condition of the components listed. This attestation certifies that the repairs appear to have been completed based on visual observation of the current condition. This certification is limited to the current visible condition observed at the time of inspection and does not constitute a guarantee regarding concealed conditions, structural integrity beyond visual observation, quality of workmanship not visible, latent defects, future performance of repairs, or conditions that may develop after the date of inspection. This report is provided for insurance underwriting purposes.
Calvin Williams
Calvin Williams, FL License #HI-14823
Date: March 12, 2026
Homeowner Signature
John & Maria Rodriguez
DISCLAIMER: This Proof of Repair Inspection report documents the current observed visible condition of previously claimed and repaired components. It is based solely on visual inspection conducted on the date indicated and does not include destructive testing, engineering analysis, or evaluation of concealed conditions. The inspector makes no warranty or guarantee regarding the longevity, hidden defects, or future performance of any repair. This report is intended for insurance underwriting purposes only and is valid for 12 months from the inspection date.