Please fill out the form below to submit a case or claim
Contact Name: (required)
Company: (required)
E-mail: (required)
Street Address:
Street Address Line 2:
City:
State / Province / Region
Postal / Zip Code:
Country: ---United StateCanada
Phone:
Case/Loss Name:
Name of Insured/Client:
Name of Claimant:
date of loss:
Claim Number/Your File Number:
Description of Loss:
Loss Location:
Date of Inspection:
Preferred Engineer:
Upload a File:
Upload a Second File:
*** By submitting this form electronically to CED Technologies Inc.: CED Technologies Inc. (CED) has not been officially retained for this matter and this can only be done after CED has a signed retainer agreement with the client. CED does not give permission for any person or entity to represent a contract with CED and to do so is unlawful.***