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Cargo Shortage and Damage Claim Form
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Submission Date: [*] Denotes Required Field

General Customer Information:
Company Name*
Contact Name*:
Phone*:
Email*:
General Shipment Information:
Carrier Name*
BOL Number*:
PRO Number*:
Ship Date*:
Delivery Date*:
Subject*:
Attach File:*:

This claim is hereby filed for: (Check One)

Shortage Damage

Was the shortage or damage noted on the DR/POD? (Check One)

Yes No

If damage claim, can product be repaired? (Check One)

Yes No (Keep your packaging & damaged freight if it cannot be repaired.)

CLAIM MUST BE SUPPORTED BY A DETAILED STATEMENT SHOWING HOW THE AMOUNT WAS DETERMINED.
INCLUDE A COMPLETE DESCRIPTION OF LOST ITEMS: SIZE, COLOR, MARKINGS, ETC.

Were the articles:Check One)

New Used

Short or Damaged Information Only
Article Description Qty Weight Unit Cost $ Amount Claimed
TOTALS $ $

NOTE: Claim should be supported by the following documents. Failure to include sufficient documentation may delay conclusion of the claim.
Documentation of value/amount claimed
Complete vendor invoice or photocopy showing all discounts*
Original repair invoice or photocopy showing hours to repair, labor rate, and material cost*
Documentation that loss or damage occurred
Noted consignee copy of DR/POD*
*Without this document(s), your claim cannot be processed.

Comments:

Express Logistics will assist in the handling of cargo shortage and damage claims. This will entail Client providing information to Express Logistics for the claim filing to the specified carrier. Express Logistics will not be responsible for any claims that are denied for any reason by the specified carrier. Client agrees to pay the freight, as invoiced, to Express Logistics. If Express Logistics recovers any costs for Client, Express Logistics will issue 100% of the claim amount back to Client. Express Logistics cannot be held responsiblefor any type of product liability.

In lieu of a signature, please fill out the following:
(All "in lieu of" info is required)




   

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