Submit a Project Project Submission Form Customer Information Title Dr. Mr. Ms. Mrs. First Name * Last Name * Email * Address * Company or Organization * Address Line 2 City * State * AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code Phone Number * Extension Claim Details Carrier Claim number Name of Insured * Loss Address Loss Address Line 2 Loss City Loss State AL AK AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Loss Zip Code Insured Phone Number Date of the loss Please enter the approximate date on which the loss occurred. What failed Loss Details Video, Photo, or File Upload. Please include any documents that are relevant to this loss. Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 2.1MB Logistics and Reporting Expedited Reporting * Yes! Please contact me ASAP with Expedited Reporting of examination results. A $75 surcharge applies. No thanks. Standard reporting (approximately 15 business days) is fine. Need results quickly? Select our Expedited Reporting option and you will be contacted within 24 hours of your evidence arriving at Veritas Engineering Laboratories. Reporting * Verbal Report Written Report Shipping to Veritas Engineering Laboratories * I will ship this item to Veritas. I would like for Veritas to handle shipping. (Additional charges may apply.) Post-Examination Storage * Store evidence. (FREE for 60 days) Return evidence immediately following the inspection. Return Shipping * Return the evidence to my address. Return the evidence somwhere else. Please enter the contact person and address to which the evidence be returned. Terms and Conditions * I agree with Terms and Conditions .