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About
Our Company
Our Team
What We’re Doing
Events
Markets
Suppliers
ICI Brands
Distribution
Food Safety
Submit Your Claim Request
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your information
Need to file a claim? Fill out the form below to submit a claim request.
Claim Form
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Please enable JavaScript in your browser to complete this form.
Type of Claim
*
Please Select
Freight Claim
Shortage Claim
Pricing Claim
- Freight Claim: for product damaged or lost by the carrier
- Shortage Claim: order shows up with less than originally ordered
- Pricing Claim: final price is in dispute
Company Name
*
Name
*
First
Last
Email
*
Send Credit Memo to Submitter?
*
Yes
No
Final Credit Memo Email
*
Purchase Order #
*
Customer #
*
Item(s) & Qty
*
Please type each item on a new line
Estimated Dollar Value of Claim
*
Additional Comments
Bill of Lading
*
Click or drag files to this area to upload.
You can upload up to 4 files.
Maximum upload limit is 10MB.
Required for Freight Claims: Signed Delivery Ticket from Carrier Driver with Damage Noted. Credit claim may be denied due to lack of information provided.
Photo
*
Click or drag files to this area to upload.
You can upload up to 10 files.
Maximum upload limit is 10MB.
Required for Freight Claims: Pictures of the damaged product. Please send as many pictures as you can showing damage from carrier. File Formats Allowed: .png, .jpg, .doc, .pdf, .jpeg
Submit
