CLAIM REQUEST

Customer Number (begins with 00-)

First Name

Last Name

Job Title

Company Name

Work Phone

Email Address

Billing Address

City

State

Zip Code

Country

Shipping Address (if different)

Reference Number Reference Number PO Number Invoice Number Sales Order Number

Enter Reference Number here

Date of Reference Number

**My claim is regarding** **My claim is regarding** Damage Pricing Product Return Incorrect Item Received/Ordered Other

DAMAGES: In order to process your claim, Polar Tech will request the following required the documents. PLEASE NOTE IF REQUIRED DOCUMENTATION OF CLAIM IS NOT PROVIDED, CREDIT WILL NOT BE APPROVED. REPLACEMENTS ARE ONLY USED AS LAST RESORT OPTION. Select all documents that you can and will provide. DAMAGES: In order to process your claim, Polar Tech will request the following required the documents. PLEASE NOTE IF REQUIRED DOCUMENTATION OF CLAIM IS NOT PROVIDED, CREDIT WILL NOT BE APPROVED. REPLACEMENTS ARE ONLY USED AS LAST RESORT OPTION. Select all documents that you can and will provide. Signed Delivery Receipt noting damages Photos of damaged product FIFO tag (found on full trays of product), Certification Stamp (found on bottom of corrugated box) or Date Stamp found on side of refrigerant boxes Additional documentation may be requested by our Order Support team Other

Freight Carrier

PRO Number

Item Number(s)

Quantity Damaged (per item listed)

General Description of Damage

Do you want to continue using this carrier? (Yes or no) Please comment.

PRICE DISCREPANCY: In order to process your claim, Polar Tech will request the following required the documents. PLEASE NOTE IF SUPPORTING DOCUMENTATION IS NOT PROVIDED, CREDIT REQUEST WILL NOT BE APPROVED. Select all documents that you can and will provide. PRICE DISCREPANCY: In order to process your claim, Polar Tech will request the following required the documents. PLEASE NOTE IF SUPPORTING DOCUMENTATION IS NOT PROVIDED, CREDIT REQUEST WILL NOT BE APPROVED. Select all documents that you can and will provide. Polar Tech Price Quote Original Purchase Order Supporting emails if applicable Other

Item Number(s)

Quoted Pricing

Invoiced Pricing

General Description of Price Discrepancy

PRODUCT RETURN: PLEASE NOTE RESTOCKING FEES AND RETURN FREIGHT MAY APPLY. Returns must be requested within 30 days of product being received to delivery location. Customers are responsible for return freight and a 30% restocking fee. Only unopened and sellable product will be eligible for credit. Any damaged items will not be credited. Custom items cannot be returned. Polar Tech must be notified of the return PRIOR to being received. If we are not aware of the return, and it arrives without authorization, Polar Tech will not accept it; it will return to you. Click 'Yes' below to acknowledge you have read this, understand and agree. PRODUCT RETURN: PLEASE NOTE RESTOCKING FEES AND RETURN FREIGHT MAY APPLY. Returns must be requested within 30 days of product being received to delivery location. Customers are responsible for return freight and a 30% restocking fee. Only unopened and sellable product will be eligible for credit. Any damaged items will not be credited. Custom items cannot be returned. Polar Tech must be notified of the return PRIOR to being received. If we are not aware of the return, and it arrives without authorization, Polar Tech will not accept it; it will return to you. Click 'Yes' below to acknowledge you have read this, understand and agree. Yes No

Has the item(s) been used or re-purposed? Has the item(s) been used or re-purposed? Yes No

Reason(s) for the Return

Item number(s) you wish to return

Quantity per item

General Description of Product Return

INCORRECT ITEM RECEIVED/ORDERED: In order to process your claim, Polar Tech will request the following required the documents. Select all documents that can and will provide. INCORRECT ITEM RECEIVED/ORDERED: In order to process your claim, Polar Tech will request the following required the documents. Select all documents that can and will provide. Photos of incorrect product FIFO tag (found on full trays of product), Certification Stamp (found on bottom of corrugated box) or Date Stamp found on side of refrigerant boxes Additional documentation may be requested by our Order Support team Other

Item(s) Number Ordered

Quantity (per item), include Unit of Measure (Case/Tray/Skid/etc)

Item Number(s) Received:

General Description of Incorrect Item Received/Ordered:

OTHER CLAIM NOT LISTED ABOVE: Tell us about your claim. Include as many details as possible.