Easy Claim Form

Easy Claim Form
Company Name*
Account #
If you aren't sure leave empty
Dealer Confirmation Email*
example@example.com
Dealer Confirmation Email 2
example@example.com
coolCARE Agreement Confirmation
coolCARE Agreement #
Equipment Serial #
Contractor Service Work Order*

Include the Model and Serial Number of equipment on all work orders. Service dates for when you originally went out and when you made the repairs, if not done all on the same day. Reason why the contractor was called out and what the technician found. NOTE: The service ticket must specify the type of repair and its location.
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Parts Invoice*

Supply house invoice for all parts in or out of OEM warranty for verification.
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Did you go beyond 30 miles from your home office? if Yes, Enter how far 1 direction
30+ miles = $1 per mile beyond
Repair Type:*
Example: compressor, blower motor, evap coil, thermostat, etc.
Leak Repair or burnt wire Picture

For leak repairs & electrical repairs, pictures are required
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Was refrigerant required to recharge the system?

YesNo
What type of refrigerant?
How many lbs
What is your current cost for this refrigerant cost?
Most recent Refrigerant Invoice for this type of refrigerant

For leak repairs & electrical repairs, pictures are required.
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THANK YOU for providing exceptional service to your customers! We'll upload your claim to the dealer portal and provide you a claim #. To check the payment status login to your account at

http://coolcare.trinitywarranty.com
Claim Status

SubmittedDenied
Claim #
Should be Empty: