Service Claim Settlement Notice

SERVICE CLAIM SETTLEMENT NOTICE PAGE NO. 1

--------------------------------:NUMBER ZQSC 281498 00 DATE 23JAN2023
PROCESSOR: :---------------------------------------
CATERPILLAR AMERICAS C.V. :REFERENCES:
BOITE POSTALE 6000 : PROCESSOR CLAIM NO. A462728 ZQ
1208 GENEVA GE : CLAIMANT CLAIM NO. OTH14996 R080
SWITZERLAND : INITIAL CLAIM NO. 3014311 R080
--------------------------------:---------------------------------------
CLAIMANT: :TERMS: AZZW5
FERREYROS S.A. : NET DUE 25TH OF MONTH
JR. CRISTOBAL DE PERALTA : AFTER INVOICE DATE
NORTE 820 :CURRENCY: UNITED STATES DOLLARS
15000 LIMA LIM :---------------------------------------
PERU :OTHER:
: SERIAL NO/SLS MDL- FDB02107/793D
: DELIVERY DATE - 09APR22 E 09APR22
: CLAIM TYPE - DBT COVERAGE TYPE -
: PARTS OPTION - B RMC - S TEPS-NONE
------------------------------------------------------------------------
CLM-Q ADJ-Q NA-Q ALW-Q DESCRIP CLAIM AMT NON-ALW AMT ALLOW AMT
1.0 OTHER 376.44 376.44

DESCRIPTION CLAIM AMT NON-ALLOW AMT ALLOW AMOUNT

MISCELLANEOUS 376.44DB 376.44DB

TOTAL 376.44DB 376.44DB

TOTAL 376.44DB 376.44DB

TOTAL 376.44DB

CLAIM GRAND TOTAL 376.44DB

NOTES:

ZQ A48 ADJUSTMENT - SEE CLAIM STORY FOR

EXPLANATION

%% ------
%%THIS CLAIM HAS BEEN IDENTIFIED AS ERRONEOUS AS PER CFIS
%%INTERNAL REVIEW FOR JAN 2023 HENCE DEBITED.
%%REASON FOR DEBIT: - LABOR NOT COVERED ON SWF PWT COVERAGE.
%%
%%DEBITING $376.44
%%----
%%DEBIT REQUESTOR: - BYRON WHITE
%%REQUESTOR PHONE: - 619 341 8007
%%REQUESTOR EMAIL: - BYRON.WHITE@CAT.COM
%%----

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