CLAIM ENTRY

 
 
Fields marked (*) are Mandatory
 
 
 
 
*Freight Bill Number
   Sail Date
   Vessel and Voyage
   Container Number
 
 
 
 
CLAIMANT INFORMATION
 
 
*Company Name
*Name Of Person Filling Claim
*Address
*City
*State
*ZipCode
*Email
*Phone
   Fax
 
  STATEMENT OF CLAIM


 
 
DETAILS
 
Explain in detail how you determined the claim amount. List the number and description of the goods, the nature and extent of loss or damage, the invoice cost, and the amount of your claim. You must have at least one Description and Claim Amount.
  Currency
 
Description Claim Amount
$
$
$
$
$
Total Amount Of Claim: $
 
 
   Comments
 
SUPPORTING DOCUMENTS
 
Correspondence supporting a claim such as: shipper's invoice, repair invoice (if applicable), proof of delivery, inspection, etc., must be faxed to (310) 537-1400 or mailed to 19201 Susana Rd, Rancho Dominguez, CA 90221, Attention: Claims Department. Without supporting documents we are unable to begin process of a claim and will be unable to consider your claim for payment.
Important! Original Vendor Invoice is REQUIRED, all other document(s) are optional.
Original Vendor Invoice Consignee Copy of Delivery Receipt (Proof of Delivery)
Copy of Bill of Lading Inspection Report, select type of report:
Copy of Paid Freight Bill
Other Original Repair Invoice
 
WHEN FOR ANY REASON, THE ORIGINAL PAID FREIGHT BILL OR BILL OF LADING IS NOT PROVIDED, CLAIMANT MUST INDEMNIFY CARRIER OR CARRIERS AGAINST DUPLICATE CLAIMS SUPPORTED BY ORIGINAL DOCUMENTS
INDEMNITY AGREEMENT
When the original bill of lading and/or freight bill is not submitted, or is not available for submission, but copies of the original are submitted in support of the claim described above, the claimant agrees to indemnify and hold harmless the carrier receiving this claim, named above, and any participating carriers, and will pay to the carrier or any participating carrier all losses, costs, damages, counsel fees or any other expenses it (the carrier) may incur resulting from all lawful subsequent duplicate claims arising out of the same shipment which may be filed and supported by the original documents.

Foregoing statement of fact is hereby certified as correct.
 
*Claimant Signature   
Date   
 
DHX Quick Links
Arrow Quick Quote
Arrow My Account
-
Quick Track
-
Advanced Tracking
-
Request New Quote
-
New Pickup/Booking
-
Reports
-
Claim Entry
-
Online Payments
-
Forgot Password
Arrow International - DGXGlobal.com
Arrow Forms
Arrow INCOTERMS 2010 Table
Arrow Personal Effects
Arrow Conversion Chart
Arrow Wood Packing Material Standard
Arrow Glossary of Terms
My Account Sign-In
Enter E-Mail:
Enter Password:
 
DHX World Clock
Guam Hawaii LA
 


DHX  Dependable Hawaiian Express, Inc., Freight Forwarding, East Rancho Dominguez, CA
DHX is a Hawaii Visitors & Convention Bureau Member