Tarkett Claim Form

Tarkett

Date Filed:

Form Completed By:

Account Executive:

Job Site and Product Information

Claim Type:

Material Type:

Invoiced Customer:

Part Number Description:

Invoiced Customer Contact/Phone #:

Invoiced Customer Email:

Item Sku:

Shade/Dyelot:

Contractor Name:

Batch:

Address:

Tarkett Invoice Number:

City / State/Prov:

Tarkett Order Number:

Zip/Postal Code:

Customer PO Number:

Contractor Contact Name/Phone #:

Installation Date:

Contractor Contact Email Address:

Completion Date:

Job Site/End User:

Address:

City" "State/Prov:

Zip/Postal Code:

End User Contact Name/Phone #:

End User Contact Email Address:

Problem Description / Comments

Material Information

Material Installed (QTY):

Unit of Measure:

Material Defective (QTY):

Unit of Measure:

Labor Amount Requested:

Defect Found:

Misc. Amount Requested:

Installed By:

Installation Information

Subfloor Grade:

Type of Substrate:

Substrate Porosity:

Status of Substrate:

Moisture Test Type (Prior to Install):

Installation Type:

Material Acclimated:

Results of Moisture Test:

HVAC:

Acclimation Time:

Adhesive Used (Resilient/Soft):

Temperature:

"Non-Tarkett" Adhesive Used (Name):

Application Method:

Primer Used (Soft):

Trowel / Nap Size:

Cleaner Used:

If "Other" Cleaner" "Please Name:

Seam Sealer Used:

Machine / Method used:

Request Outcome

Requested Outcome

PLEASE INCLUDE REPRESENTATIVE PHOTOS WITH THE FILING OF THE CLAIM FORM

Please send representative CARPET sample to:
Tarkett Claims Group 1735 Cleveland Hwy" "Dalton" "GA 30721

Please send samples via Fedex account # 037403288
Please send representative HARD SURFACE sample to:
Tarkett Claims Group" "30000 Aurora Rd." "Solon" "OH 44139

Please send samples via FedEx account # 795665978 or via UPS account # 80W965

Florence East Claim Forms shall be sent to:
TCLVTClaims@Tarkett.com

If labor is requested" "please include a copy of an itemized labor bill with the submission of this form.

Add Attachment

Tarkett Claim Form

Tarkett

(972) 241-0633