Cargo Loss and Damage Form

Please complete this form and hit "Submit" when finshed. Our site will automatically generate an email to the appropriate party.

Please attach any supporting documentation to this email.

Claimant Information

Claimant Company:		Phone Number:
Claimant Name:		Fax Number:
Address:		Email Address:
City, State Zip:

Shipment Information

ECM Order Number:		Ship Date:
Shipper Name:		Consignee Name:
Shipper Address:		Consignee Address:
Phone Number:		Phone Number:
Contact:		Contact:

Claim Details

Claimant's Reference Number:
Claim Type:	Noted Damages	Shortages	Concealed Damages
	Other

Please describe what the claim represents and show how the amount for the claim was calculated

Quantity	Product Description	Claim Amount





Total Claim Amount

If the claim involves damaged goods, please complete the following:
Damaged goods can be repaired for the amount of:	$
Damaged goods can be used "as is"for an allowance of:	$
Damaged goods are available for carrier pickup at this amount:	$
Damaged goods are unavailable (Please explain):

Hitting "Submit" will generate an email to the appropriate party at ECM TRANSPORT. To avoid delay in processing your claim, please attach the following documents to the your email before sending.

Copy of BOL
Vendor's Invoice showing price of lost or damaged goods
Consignee's copy of freight bill, bearing loss or damaged notations
Itemized repair bill
Inspection Report
Pictures of freight (if available)