NORTH COUNTRY STORE v. UNITED NATURAL FOODS, INC.

Case No. 1:19-cv-00052-WES-LDA

UNITED STATES DISTRICT COURT DISTRICT OF RHODE ISLAND

If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. ABCD123456).

If you do not have your Notice ID and Confirmation Code, please contact the Claims Administrator at info@FuelSurchargesSettlement.com.

If you need to edit your existing Claim, please enter the Submitted Claim ID and Confirmation Code exactly as they appear on the confirmation page or email.

  • This is a very simple process. To submit a claim for settlement payment related to the “Fuel Charges”, “Fuel Surcharges”, or any substantively similar fees or charges (collectively, the “Fees”) you paid to United Natural Foods, Inc., its parent companies, operating subsidiaries, operating companies, divisions and all affiliated or related entities, (collectively, “United Natural Foods, Inc.”), you must provide the information below and sign where indicated. Failure to provide this information and sign this Claim Form may result in denial of your claim(s).
  • If you do not want to rely upon the information United Natural Foods, Inc. has in its computer system, you may—but are not required to—submit the invoices you have from United Natural Foods, Inc. which the Settlement Administrator will use to create as complete a record as possible. See the Notice of Settlement for more detail.
1. Please provide the full name of your business as it appears on your contract or invoices with United Natural Foods, Inc. (if your business underwent any name changes within the last six (6) years, please include all prior business names):

Please enter the Email Address where you would like to receive your claim confirmation.

* Required Fields
2. Please provide the principal address for your business (where you received deliveries):
* Required Fields
3. Please provide the billing address for your business (your check will be mailed here. If your business is no longer in existence, please provide the address where you would like the check mailed):
* Required Fields
4. Please provide your business phone number(s):
* Required Fields
5. Please list the United Natural Foods, Inc. operating company or affiliate(s) from whom you purchased products and/or received invoices, if available (this information would appear at the top and/or bottom of the invoice):
6. Please list your United Natural Foods, Inc. Customer Number, if available (this would appear on the top of the invoices):
7. Please provide the approximate time period (month and year) during which you purchased products – and received invoices – from United Natural Foods, Inc. (for example, “September 2013 through March 2015”):
* Required Fields
8. Supporting Documents

Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

File List: No Files Selected

    CLASS MEMBER AFFIRMATION: By submitting this Claim Form and checking the box below, I declare that I am a member of the Settlement Class and that the statement below is true (the box must be checked to receive payment)

    Your Claim Form has been submitted successfully.

    HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: info@FuelSurchargesSettlement.com.

    Please print this page for your records.

    Your Claim Details

    Submitted Claim ID:
    Confirmation Code:
    You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
    CLAIM INFORMATION
    Business Name
    Street Address
    City
    State
    Zip Code
    Signature
    Date

    If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@FuelSurchargesSettlement.com.

    Click here to edit your Claim.