Claims Form

First Name(Required)

Last Name(Required)

Vendor Name(Required)

Vendor Street Address(Required)

Vendor Address Line 2

Vendor City(Required)

Vendor Province(Required)

Vendor Postal Code(Required)

Email(Required)

Alero Tracking Number(Required)

PO #(Required)

Incident Date / Delivery Date(Required)

Product Description(Required)

Dollar (CDN$) Amount of Claim(Required)

Type of Claim(Required)

Freight Damage

Loss of Freight

Property Damage

Explanation(Required)

Upload File(Required)

Please upload the following documents: Photos, Member Statement, and/or any supporting documents to prove the NLC of a product. *

Drop files here or

Max. file size: 200 MB.