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. 12345678).

Don't have a Notice ID and Confirmation Code? You can submit a Claim Form using the following methods:

1. Download a Claim Form here, print it and fill it out, and mail to Bow PEX Settlement Administrator, 1650 Arch Street, Suite 2210, Philadelphia, PA 19103.

2. Download a Claim Form here. Fill it out and send a digital copy to: info@BowPEXSettlement.com.

ATTENTION: BOW PLUMBING GROUP PEX CLASS ACTION SETTLEMENT CLASS MEMBERS:

Use this Claim Form if: (a) you owned or occupied a residential, commercial, or other structure that contains or contained Bow’s PEX Tubing labeled with a 5306 product designation, including Bow SuperPEX (hereinafter “Tubing”) and have experienced at least one leak from the Tubing that resulted in a physical escape of water causing damages; and/or (b) you paid for repairs or damages resulting from a Qualifying Leak or Multiple Qualifying Leaks from Bow Tubing in such structures. The Settlement Agreement defines these terms at Paragraphs A.1.u. and ff.

Claim Form Deadline.

If you have already experienced a Qualifying Leak, you can submit your Claim Form now. If you experienced any Qualifying Leaks between May 26, 2003 and the Effective Date, you must submit your Claim Form no later than one hundred (100) days after the Effective Date. The Effective Date will be set by the Court and has not yet been determined. It will be posted on the Settlement Website once the date is set.

If you experience a Qualifying Leak after the Effective Date and on or before December 31, 2028, then your Claim Form is due no later than one hundred (100) days after the Qualifying Leak occurs.

How To Complete This Claim Form.

  1. All questions must be answered. Use “N/A” when the question does not apply. You must respond to any request by the Settlement Administrator for additional information. If you fail to respond, your claim may not be processed and you may waive your rights to receive a monetary award under the Settlement.
  2. Please complete a separate Claim Form for each property for which you are submitting a Claim.
  3. Please keep a copy of your submitted Claim Form and all supporting materials. Do not submit your only copy of the supporting documents. Materials submitted will not be returned. All copies of documentation submitted in support of your claim should be clear, legible, and complete.
  4. There are three ways to submit your Claim Form and supporting materials: (a) by mail; (b) by email to the following address: info@BowPEXSettlement.com; or (c) via this website.
  5. If you are mailing your Claim Form and supporting materials, please include the completed Claim Form and all supporting materials in one envelope and send it to the following address:

Bow PEX Settlement Administrator
Angeion Group
1650 Arch Street, Suite 2210
Philadelphia, PA 19103

If you have any questions, please contact the Settlement Administrator by email at info@BowPEXSettlement.com or by telephone at (844) 600-6681, or write to the address above.

It is your responsibility to notify the Settlement Administrator of any change of address that occurs after you submit your Claim.

Non-Qualifying Leaks

A physical escape of water that is clearly, solely, and exclusively the result of penetration by a foreign object and/or certain installation issues is not eligible for a remedy. The Settlement Agreement defines these exclusions at Paragraph 1.ff.ii.

What to expect after you submit your Claim Form

  1. Please note that no acknowledgement will be made of the receipt of a Claim Form submitted by mail. If you wish to be assured that your Claim Form and documentation submitted by mail were received by the Settlement Administrator, please use a shipping method that provides delivery confirmation. If the Claim Form is submitted by email, a return email notification of receipt will be sent. If the Claim Form is submitted via the Settlement Website, an instant notification of receipt will be provided.
  2. The Settlement Administrator will evaluate all the information and documentation that you submit in order to determine your eligibility for monetary benefits under the Settlement, and will contact you to request additional information if the information you provided is insufficient to process your Claim.
  3. Please note that, given the need to investigate and evaluate each Claim Form, it may take several months for the Settlement Administrator to process your Claim Form. This work will be completed as quickly as possible.

If you find you cannot complete the claim form in one session, an option to “Save and Exit” is available at the bottom of each section of the claim form. If you choose this option, you will receive an email providing you with a Notice ID and Confirmation Code so you are able to login when you return, and pick up where you left off.

I. CLAIMANT CONTACT INFORMATION/MAILING ADDRESS

Provide your name and contact information below. It is your responsibility to notify the Settlement Administrator of any changes to your contact information after the submission of your Claim Form. If you are making a Claim on behalf of a business or entity, then please include your name and contact information immediately below and the identity of that business or entity where indicated further below. Please provide the information that should be used to contact you about your Claim, if necessary, or for the distribution of any potential Settlement Payment. Information you provide will only be used to process your claim(s) and administer the class, and will not be sold or otherwise used.

Please place a check in the applicable box. Are you a:

* Required Fields

II. DESCRIPTION OF PROPERTY WHERE THE QUALIFYING LEAK(S) OCCURRED

A. PROPERTY STREET ADDRESS

B. PROPERTY TYPE

C. PROPERTY OWNERSHIP

LIST ALL PROPERTY OWNERS. If there are additional owners, please attach a list with each additional owner’s full name.

Are you the current owner of the property?

If you are a builder, contractor, distributor, seller, subrogated insurance carrier, or other Person who has claims for contribution, indemnity or otherwise for amounts you paid due to leaks at the properties of others, please provide the name and contact information for your insured or the individual or entity for whom you paid a claim. (You must provide documentation and evidence of payment in order for your Claim to be complete.)

D. INSURANCE

E. HOME WARRANTY

III. IDENTIFICATION AND INSTALLATION OF TUBING

A. DESCRIPTION OF BOW TUBING

Do not submit a Claim Form unless you have or had the Tubing in your structure. You can access photos and a description of the Tubing on the Important Documents page. Only Covered Products (i.e., Bow’s PEX Tubing) are eligible for relief under the terms of this Settlement. The Tubing was used for a variety of applications including, without limitation, hot and cold-water distribution in plumbing applications in residences and commercial structures.

B. PROOF OF A COVERED PRODUCT

How have you determined that your structure contains or contained the Tubing? (Check all that apply.)

Please select at least one option.

Enclosures Required: For each document you checked above, please upload a copy (not an original) with this completed Claim Form. When submitting samples or photographs of Covered Products, please ensure the identifying markings are clearly visible.

IV. DESCRIPTION OF LOSS

A. Failed Product(s)

1. Have you replaced the Tubing that is/are the subject of the leak?

2. Have you repaired any alleged damage to your property as a result of the leak?

3. List the approximate date that each alleged Qualifying Leak occurred and the unreimbursed amount that you spent on damages or repairing the leak:

Please list at least one date and amount.

Upload additional leaks on another page, if needed.

4. For any unreimbursed amounts spent, please provide any reasonable proof, including, by way of examples only, plumber or contractor records, invoices, receipts, credit card statements, insurance records, or any other document or information that evidences the unreimbursed amount.

5. Have you been reimbursed for any replacement/repair costs from your insurance company or any other third party?

If yes, please provide:

6. Do you have Covered Product(s) that experienced a leak on or after the Effective Date?

If yes, then please provide either a photograph of the failed Product(s) or a reason why a photograph is not available for submission.

V. RE-PLUMB CLAIMS

Please fill out this section only if you have experienced Multiple Qualifying Leaks and are seeking, or have already completed, a re-plumb of the affected property.

2. Did at least two of the Qualifying Leaks occur in separate Lengths of Tubing?

3. Do you have any reasonable proof of the number of Qualifying Leaks and their locations (if in separate Lengths of Tubing)?

a. If yes, provide any reasonable proof, including, by way of examples only, of the failed product itself, plumber or contractor records, photographs, videos, invoices, receipts, credit card statements, inspection records, insurance records, or any other document or information that evidences the Qualifying Leaks and their locations (if in separate Lengths of Tubing):

4. Please select one option:

If you did not select the one-time $8,500.00 payment option, then please complete the remainder of this Section:

7. Have you already completely re-plumbed your property as a result of the leak(s)?

(you must submit invoice(s) and proof of payment to recover a re-plumb payment)

9. For any unreimbursed amounts spent, please provide any reasonable proof, including, by way of examples only, plumber or contractor records, invoices, receipts, credit card statements, insurance records, or any other document or information that evidences the unreimbursed amount.

10. Have you been reimbursed for any re-plumb costs from your insurance company or any other third party?

If yes, please state:

Please note that if you are deemed eligible by the Settlement Administrator for a Re-Plumb Claim, or accept the one-time $8,500.00 payment instead of a re-plumb payment, you will no longer be eligible to make any Future Property Damage Claims or Re-Plumb Claims.

VI. SETTLEMENTS

Have you entered into any oral or written settlement of the claims identified above, or received the benefit of any payments to you or on your behalf as a result of those claims?

If yes, also state the date and amount of settlement:

If Yes, please attach a copy of the Release or Settlement Agreement, if any.

VII. ADDITIONAL INFORMATION/DOCUMENT ATTACHMENTS

If you have any additional information which you would like us to consider in evaluating your claim, please attach that information as a separate document.

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.

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      VIII. RELEASE, CERTIFICATION, AND AGREEMENT TO BE BOUND

      I/we declare that the information that I/we have supplied in this Claim Form is true and correct to the best of my/our knowledge and belief and that this document is signed pursuant to 28 U.S.C. § 1746 under penalty of perjury. By signing below, I/we hereby certify that I/we have read the Release in Paragraph 34 of the Settlement Agreement and agree to be bound by the Release and the terms of the Settlement Agreement.

      THIS FORM WILL BE USED BY THE SETTLEMENT ADMINISTRATOR TO DETERMINE YOUR ELIGIBILITY TO RECOVER UNDER THIS SETTLEMENT AND TO DETERMINE THE VALUE, IF ANY, OF YOUR SETTLEMENT RECOVERY.

      ACCURATE CLAIMS PROCESSING TAKES TIME.
      THANK YOU FOR YOUR PATIENCE.

      REMINDER CHECKLIST

      1. Please check to make sure you have answered all of the questions on the Claim Form.
      2. Please sign and date under penalty of perjury
      3. Remember to upload copies of all required supporting documentation.
      4. Keep a copy of the completed Claim Form and supporting documentation for your records.
      5. If you move, or if the Notice of Settlement was sent to you at an old or incorrect address, please provide us with your new mailing address.
      6. If you have any questions, contact the Settlement Administrator by calling (844) 600-6681, by emailing info@BowPEXSettlement.com, or by writing to:

      Bow PEX Settlement Administrator
      Angeion Group
      1650 Arch Street, Suite 2210
      Philadelphia, PA 19103

      Your Claim Form has been submitted successfully.

      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
      First Name
      Last Name
      Mailing Address 1
      Mailing Address 2
      City
      State
      Province
      Zip Code
      Postal Code
      Country
      Email Address
      Home Phone
      Cell Phone
      Work Phone
      Signature
      Date

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

      Click here to edit your Claim.

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