skip to Main Content

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:

    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.***

    Back To Top