Page 172 - claims information pack ebook_e

Example Claim Form
Claim Number (for internal use only) PART 2 Section C Section C
Economic loss in the fisheries, mariculture
and fish processing sectors

Summary of the claimed loss
14) Brief description of loss incurred and explanation of how the loss occurred

15) Claim period

From ...............................to ...............................

16) Details of the age of the stock at the time of contamination and the normal planned harvest date(s)
of the stock

Revenues by month for the period of loss claimed and in the preceding three years of fishing/mariculture/
fish processing.
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The example table below should be completed for the three years before the incident, as well as for the claim
period. If necessary, please use additional pages clearly marking them, to show to which question and time period
they relate. Templates of this table and other similar spreadsheets can be downloaded from the IOPC Funds website.

Date or period Income per month
of activity Species caught/ Volume or Price per
weight caught/
harvested harvested/ sold kilogram on
date of sale
Month Year Gross Net

Total
17) Total net loss during claim period (from table above)

Details of any savings

18) Saved overheads or other normal variable expenses due to the incident (e.g. sales commission, cost of
fuel, gas and electricity, diesel, feeding costs, ice for storage, packaging, maintenance, cost of fish, food
for fish etc. which were not purchased or used) (see box 19 below for saved labour costs)

19) Saved labour costs (if labour/staff have been released or have worked reduced hours)