Standard Freight Claim Form – Focus1 Logistics

CONTACT DETAILS

Company Name:

Address:

City:

Province/State:

Postal Code/Zip Code:

Contact Name:

Contact Number:

Email:

CLAIM DETAILS

Date:

Delivery Date:

Commodity Type:

Claimant:

Delivering Carrier:

PO Number:

Vendor Name:

Carrier's Pro Number:

Focus Reference Number:

Controlled Label: Y / N

Yes

Note: On controlled label goods where no salvage is available claim will be declined on that basis

Name of Label:

Please accept this intent to claim in the amount of $ CDN.

This product was:

Short

Damaged

Item Number

Quantity

Description

Cost

Total

Total Claim:

INTENT TO CLAIM

Please provide a detailed statement showing how amount claimed has been determined (i.e. Number and description of articles, nature and extend of Loss/Damage, invoice price per unit, etc.)

Provide a detailed written statement explaining:

Nature and extent of loss or damage
How the total claim amount was calculated
Invoice value per unit (USD) and quantity affected
Supporting cost documentation (invoices, repair estimates, replacement quotes)
Whether goods are repairable, salvageable, or destroyed
If salvage applies, location and condition of goods
If destroyed, include destruction documentation and date

Comments:

Disposition of Goods:

Goods available for carrier inspection
Salvage available
Goods destroyed (documentation required)

REQUIRED DOCUMENTS

PLEASE NOTE: In order to process this claim, the following documents must be submitted with this form:

Signed Proof of Delivery (POD) Original Bill of Lading Commercial / Supplier Invoice Inspection Report (if applicable) Photos of Damage (if applicable)

Claims submitted without this information cannot be processed

Signature of Claimant:

Date:

Email all information to: Focus West Logistics Claims Department at Admin@focuswestlogistics.ca

VALUATION & LIABILITY NOTICE

Carrier liability is governed by the Carmack Amendment (49 U.S.C. § 14706), the applicable Bill of Lading, and the FOCUS 1 LLC Freight Claim Terms & Conditions. Unless a separate written Contract Liability Agreement applies, liability is limited to the actual loss or damage at the time and place of shipment.
FOCUS 1 LLC and any underlying carrier are not liable for consequential damages, lost profits, administrative expenses, duties, taxes, indirect damages, or special damages. If a written Contract Liability Agreement applies, that agreement shall control and supersede default Carmack provisions to the extent permitted by law.

CERTIFICATION & ACKNOWLEDGMENT (REQUIRED)

I certify that the information provided in this claim is true and accurate. I acknowledge and agree that this claim is governed by the FOCUS 1 LLC Freight Claim Terms & Conditions, the applicable Bill of Lading, and federal law including the Carmack Amendment (49 U.S.C. § 14706). I understand that strict filing deadlines apply, salvage rights must be preserved, and submission of this claim does not guarantee payment.

FREIGHT CLAIMS

How to Submit a Freight Claim

Standard Form for Loss & Damage Claims

FOCUS 1 Logistics, LLC Freight Claim Terms and Conditions

1. Governing Law

2. Filing Deadlines

3. Mandatory Written Claim Requirements

4. Proof of Delivery and Inspection

5. Concealed Damage

6. Required Documentation

7. Freight Charges

8. Inspection, Mitigation, and Salvage

9. Limitation of Liability

10. Claim Processing Timeline

11. Claim Submission