File A Claim

Please Fill Out all required fields marked with an asterisk (*).

Click here to download a printable PDF version of this form.

Contact Details
Company*
Address*
CIty*
Province/State*
Postal Code/Zip Code*
Contact Name*
Contact Number*
Email*
Re-type Email*
Claim Details
Commodity Type*
PO Number*
Radius Logistics Reference#*
Please accept this intent to claim*
In the amount of $CDN*
Shipment Details
Shipment #1
Description
Quantity
Unit Cost $
Freight
Type
Subtotal
Shipment #2
Description
Quantity
Unit Cost $
Freight
Type
Subtotal
Shipment #3
Description
Quantity
Unit Cost $
Freight
Type
Subtotal
Total Claim Amount $
Intent to Claim
Please provide a detailed statement showing how amount claimed has been determined (id. Number and description of articles nature and extend of Loss / Damage, invoice price per unit, etc.
Comments:
Damaged goods can be repaired for approximately:
Damaged goods can be used as is for an allowance of:
Damaged goods
- Damaged goods are available for pickup
- Damaged goods are not available for pickup (please explain below).
Damaged Goods Comments: