Name of insured Thomsons Trucks
Address 18 The Mint Yard St Stephen’s Gate, Westhampton
Tel No. 24246
Consignors Hotel interiors PLC
Address 108 Hickstead Road
Consianess Brampton Hospital
Address Scotby Road Brampton
If theft or loss, which police station was advised and when?
………………………………………….
If damaged, where are the damaged goods now?
………………………………………….
Are there other policies covering the consignment in question?
………………………………………….
YES / NO
Gross amount of claim £ 560
Salvage value if any £ ………………….
Net amount of claim £ ………………..
Number of vehicle HJ 660Y
Make of vehicle Leyland
Name of driver Peter Ross
Age 25
Length of service 2 Years
Name of witness …………………..
Address …………………..
………………………………………………………………… ……
Date on which goods collected 14th January
Date on which goods delivered 15th January
Signature given on collection?
YES/NO
Name of signatory Peter Rose
Was receipt Clear / claused?
Signature obtained on delivery
YES/NO
Name of signatory M banks
Clear/claused 4 chairs short
Nature of load furniture
No of items in load 30
Weight
………………………..
Nature of goods lost/damaged 4 chairs
Amount of goods lost/damaged 4 chairs
We declare the foregoing particulars to be true in every respect
Signature JOE CLARK
Date 20th January
Position transport manager
Please complete the statement of claim overleaf please turn over
1. Q : Who sent the chairs?
A : Thompson Jack
2. Q : Who were the chairs sent to?
A : Joe Clark
3. Q : What happened to the chair?
A : Not all the chairs arrived,and the transport sompany was held responsible.
4. Q : How much did the chairs cost?
A : The cost was $2240
5. Q : What is the total amount being clamed?
A : The total amount being claimed is 4 chairs.
6. Q : When the driver examined the consignment in Westhampton was everything in order?
A : 2 years
7. Q : Was the consignment checked when the chairs were delivered?
A : Yes,it was
8. Q : What comment was made in the delivery note which caused it to be claused?
A : 4 chairs is was short.
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