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By using this service, you can expedite the handling of your claim.  After you complete the notice, it is sent electronically to the appropriate claims department personnel who will contact you within 24 hours.  For more information visit the Claim Notification Center.

Please note that while we have included facsimile and email contact information, some bond forms and statutes do not recognize email or facsimile delivery as acceptable methods of perfecting claims against a bond. Nothing herein shall be deemed a waiver or estoppel by Philadelphia Indemnity Insurance Company of any of its rights and defenses, including but not limited to, any defenses associated with the content, timing, and form of delivery of claim notices.

Surety

 
    required  Denotes Required Fields
Claimant Contact Information
Claimant Name required
Contact Name required
Email Address of Person to Contact required
Phone Number of Person to Contact required  -  -

Principal Profile Principal Name
Principal Street Address
Principal City
Principal State
Principal Phone  -  -

Principal Email
Bond and Project Information Bond Number
Project/Contract Description
Project/Contract Location
Obligee/Project Owner
Description of Claim Amount of Claim
Date of Last Supply of services, labor, or materials
To whom did Claimant supply services, labor or material (if different than Principal)
PLEASE NOTE: Many bonds contain unique and specific notice requirements that must be followed in order to perfect a claim against the bond. Bonds may also be subject to State and Federal notice requirements. We encourage each claimant to obtain an executed copy of the final bond from the obligee to ensure that it is complying with the required form of claim notice, method of delivery, and timing requirements. Applicable statutory notice provisions should also be consulted. Submission and receipt of this online claim form shall not constitute a waiver, estoppel or other release of Philadelphia Indemnity Insurance Company’s defenses relative to Claimant’s compliance with notice requirements of the Bond and applicable law.
File Attachments  
Following packages will be used to scan file(s):
* McAfee VirusScan Enterprise
Allowed file types:
  .doc .docx .pdf .jpg .jpeg .gif .bmp .png .tif .rar .zip .xls .xlsx

File size is limited to 3 (MB) per file. Maximum Files: 5 
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