Delivery Service Non-Delivery Form

Delivery Service Non-Delivery Form

Recitals

WHEREAS, Carrier Name: and Client Name: are parties to a delivery services agreement under which Carrier provides pickup, transport and delivery services for certain shipments; and

WHEREAS, a delivery attempt was made in respect of a shipment identified below and delivery was not completed; this document memorializes the facts of non-delivery, the disposition of the shipment, and the parties' agreement regarding redelivery, storage, charges and next steps.

Shipment & Attempt Details

Pickup Date:   Scheduled Delivery Date:

Attempted Delivery Date:   Time:

Item Count:   Total Weight:   Declared Value: $

Non-Delivery Reason(s) and Disposition

Indicate reason(s) for non-delivery (check all that apply):

Left notice at premises

Recipient unavailable / no access to premises

Refused by recipient

Address incorrect / incomplete

Returned to depot / held for pickup

Weather or service interruption

Other (describe)

Notice Left Date:   Time:

Scope of Work

The Carrier shall provide the following services in relation to this non-delivery event. This Scope of Work sets out the specific duties, timelines, and responsibilities related to redelivery, storage and final disposition of the shipment.

Payment Terms

Charges for redelivery, storage, and related administrative fees shall be invoiced to Client. Payment is due as set forth below.

Payment Due Within:   Billing Contact:

By signing this form the Client authorizes invoicing for the fees identified above and acknowledges that undisputed amounts not paid when due shall accrue the stated late fee and may be subject to recovery costs, including collection fees and legal costs.

Term and Termination

This non-delivery handling arrangement is effective for the period identified below and may be terminated consistent with the notice provisions set forth.

Term Start Date:   Term End Date:

Confidentiality

Each party shall treat as confidential any nonpublic information disclosed in connection with this non-delivery event, including shipment contents, declared value, billing details and any security or routing information. Confidential information shall not be disclosed except to employees, agents, contractors or advisors with a need to know, and then only subject to confidentiality obligations at least as protective as those set forth herein. This confidentiality obligation survives termination of this form for a period of two years.

Governing Law; Entire Agreement

Governing Law: The rights and obligations of the parties under this form shall be governed by and construed in accordance with the laws of the State/Province specified below, without regard to conflict-of-law rules.

Entire Agreement: This document, together with any referenced delivery agreement and any incorporated invoices, constitutes the entire agreement between the parties with respect to the matters described herein and supersedes all prior or contemporaneous understandings and communications, whether written or oral.

Next Steps, Notices & Claims

Next steps for redelivery or pickup shall be as indicated below. Claims for loss or damage must be submitted in writing in accordance with the Carrier's claims procedures and within the applicable claim period specified in the governing delivery agreement.

By signing below, the undersigned parties certify that the information recorded on this form is true and accurate to the best of their knowledge, that the Carrier has complied with applicable carrier procedures for attempted delivery, and that Client understands applicable fees and next steps for redelivery or disposition.

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