Form For Presentation Of Loss And Damage Claims
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1Estes Express Lines
Post Office Box 25612
Richmond, Virginia 23260
Phone #(804) 353-1900 Ext. 2234, 2236 or 2581
Fax #(804) 359-3148
Form for Presentation of Loss and Damage Claims
Claimant
________________________________________
Date Claim Filed
_______________
Address
________________________________________
Your Reference No._______________
________________________________________
Email Address ___________________
Claim Amount $
_________________ is made against Estes Express Lines by _____________________________
_________________________________________________________ for
Loss
Damage
Name of Shipper
________________________________________Address _______________________________
Name of Consignee________________________________________Address _______________________________
Bill of Lading No. ________________________________________Date of B/L _____________________________
Estes Freight Bill No._______________________________________Dated
_______________________________
(DO NOT OMIT THIS NUMBER)
STATEMENT OF LOSS OR DAMAGE and number and description of articles, nature and extent of loss or damage,
item number and invoice price of article, amount of claim, etc., and disposition of salvage, if any.
THE MERCHANDISE CHECKING SHORT FOR WHICH THIS CLAIM HAS BEEN FILED HAS NEVER BEEN
RECEIVED FROM ANY SOURCE.
THIS CLAIM IS FILED BY THE OWNER OF THE MERCHANDISE WHO HAS LEGAL RIGHT TO COLLECT FOR
THE LOSS OR DAMAGE THAT HAS OCCURRED TO THE SHIPMENT IN QUESTION.
THE FOLLOWING DOCUMENTS ARE TO BE SUBMITTED IN SUPPORT OF THIS CLAIM:
1) Original Bill of Lading.
2) Original paid Freight Bill.
3) Original invoice: Photostat or certified copy from vendor.
4) Copy of all invoices for replacement parts, material and labor incurred in repairs if applicable to claim.
ALL CLAIMS MUST BE FILED WITHIN 9 MONTHS OF DATE OF DELIVERY. CARRIER HAS 120 DAYS IN WHICH
TO CONCLUDE FROM DATE CLAIM IS RECEIVED. YOU MUST RETAIN ALL SALVAGE ON DAMAGE CLAIMS
UNTIL DISPOSITION OF THE CLAIM IS KNOWN.
The foregoing statement of facts is hereby certified
to be correct:
__________________________________________
Signature of Claimant
(
PLEASE EITHER MAIL OR FAX YOUR CLAIM, BUT NOT BOTH)
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