# OF
PIECES
DESCRIPTION OF COMMODITY
NEW OR
USED?
TOTAL AFFECTED
WEIGHT
COST PER
UNIT
AMOUNT OF
CLAIM
TOTAL
$
$
$
$
$
$
$
$
$
$
$
$
$
Damage
Concealed Damage
Damage AND Shortage
Complete Shortage (missing)
Partial Shortage
Concealed Shortage
Claim Type (must check one)
Claimant (Company):
Address Line 1:
Address Line 2 (Optional):
Ext.:
Pro Number:
Date of ling:
State/Province:
A cargo claim is a demand for compensation given by a carrier for any loss or
damage to goods caused by that carrier. Please refer to NMFC Rule 300100
and Title 49 Part 370 for cargo claim submission and processing guidelines.
In the event of concealed damage (damage or loss within the shipping con-
tainer(s) that could not have been determined at the time of delivery), notice
of such damage or loss must be provided to the carrier within 5 business days
from the date of delivery.
All claims must be submitted within 9 months of delivery unless further restrictions apply.
Refer to items 779 & 780 in the
CT100
Rules Tariff
for any limitations of liability.
Please direct all claims related correspondence to: cs.claims@centraltransport.com
To check the status of a claim, please visit www.centraltransport.com
To submit claim, send completed form and all supporting documents to:
By email: cs.claims@centraltransport.com
By mail: CENTRAL TRANSPORT
ATTN: CLAIMS DEPARTMENT
12225 STEPHENS ROAD
WARREN, MI 48089
By fax: (586) 467-1756
Required Supporting Documents (Claims without proper support are subject to denial):
Cost Verication (Mfg Cost or Original Invoice)
Inspection: Central Transport requires a self-inspection for damage
claims over $500. A joint third party inspection may be required for
damage claims over $5,000.
Burden of Proof (Pictures, statements, etc)
CARGO LOSS/DAMAGE CLAIM
If Claimant is 3rd party or not listed on BOL, Claimant is representing:
City:
Zip/Postal Code:
Email Address:
Phone Number:
Claimant’s signature:
Claimant (Contact Person):
Claimant (Ref#):
