ALABAMA AND TEXAS PEX SETTLEMENT

Matson v. NIBCO Inc., Case No. 19-cv-01137-RBF-JKP (Western District of Texas), and

Garrett. v. NIBCO Inc., Case No. 19-cv-01137-RDP (District of Alabama)

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).

If you are returning to a saved claim, enter a Notice ID and Confirmation Code as it appears in the received email.

OR

If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

ATTENTION: NIBCO PEX CLASS ACTION SETTLEMENT CLASS MEMBERS:

Use this Claim Form if: (a) you owned or occupied a residential structure in certain Alabama and Texas cities that contains or contained NIBCO 1006 Tubing (“Tubing”), NIBCO F1807 Fittings (“Fittings”), and/or NIBCO Stainless Steel Clamps (“Clamps”) and have experienced at least one leak from the Tubing, Fittings, and/or Clamps that resulted in a physical escape of water causing damage; and/or (b) you paid for repairs or damages resulting from a Qualifying Leak from NIBCO Tubing, Fittings, or Clamps in such residential structures.

The list of residential structures included in the Settlement can be found on the Important Documents page. Please do not submit a Claim Form to this Settlement if the leak occurred in a structure not included on this list.

A physical escape of water that is 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.gg.iv.

Claim Form Deadline.

Claim Forms can be submitted starting immediately.

Claim Forms are due 100 days after the Effective Date for Qualifying Leak(s) that occurred between January 1, 2005 and the Effective Date. The Effective Date was October 12, 2022. The deadline to submit a claim for leaks that occured between January 1, 2005 and the Effective Date was January 20, 2023.

Claim Forms are due 100 days after the Qualifying Leak occurs if the Qualifying Leak occurs after the Effective Date and on or before May 16, 2025.

How To Complete This Claim Form.

  1. Please type or print your responses in ink.
  2. 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.
  3. Please complete a separate Claim Form for each property for which you are submitting a Claim.
  4. 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.
  5. There are three ways to submit your Claim Form and supporting materials: (a) by mail; (b) by email to the following email address: info@AlabamaTexasPEXsettlement.com; or (c) via this website.
  6. 6. 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 to the following address:

Alabama Texas PEX Settlement
ATTN: CLAIMS
1650 Arch Street, Suite 2210
Philadelphia, PA 19103

If you have any questions, please contact the Settlement Administrator by email at info@AlabamaTexasPEXsettlement.com or by telephone at 1-855-976-0649, 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.

What to expect after you submit your Claim Form.

  1. Please note that no acknowledgment will be made of the receipt of a Claim Form. If you wish to be assured that your Claim Form and documentation were received by the Settlement Administrator, please use a shipping method that provides delivery confirmation.
  2. Please note that it will take several months for the Settlement Administrator to process your Claim Form. This work will be completed as quickly as possible, given the need to investigate and evaluate each Claim Form.
  3. The Settlement Administrator will evaluate all of 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.

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.

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 OWNERSHIP

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

1.

2.

Are you the current owner of the property?


3.

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 person for whom you paid a claim. (You must provide documentation and evidence of payment in order for your Claim to be complete.)


C. HOMEOWNERS INSURANCE

III. IDENTIFICATION AND INSTALLATION OF TUBING, FITTINGS, and CLAMPS

A. DESCRIPTION OF NIBCO PEX TUBING, FITTINGS, and/or CLAMPS

Do not submit a Claim Form unless you have or had the Tubing, Fittings, and/or Clamps in your structure. You can access photos and a description of these products on the Important Documents page. Only covered NIBCO Products are eligible for relief under the terms of this Settlement. The Tubing, Fittings, and Clamps were used for a variety of applications including, without limitation, hot and cold water distribution in plumbing applications in residences. Please note that the Tubing, Fittings, and Clamps at issue in this Settlement are likely no longer on the market. The Tubing was sold between 2005 and approximately 2013. The Fittings were sold between 2005 and approximately 2015. The Clamps were sold between August 2005 and approximately August 2015.

B. PROOF OF A COVERED PRODUCT

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

Please select at least one product.

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. Click here to view images of the covered products.

IV. DESCRIPTION OF LOSS

A. Failed Product(s)

1. Which Covered Product(s) do you allege leaked (check all that apply)?

Please select at least one product.

2. Have you replaced the Product(s) that is/are the subject of the leak?

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

4. 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.

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

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. Please select one option:

If you did not select the one-time $3,000 payment option, then please complete the remainder of this Section:

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

5. For any work described above, please state the unreimbursed amount paid out-of-pocket by you:

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

If Yes, state:

Please note that if you are deemed eligible by the Settlement Administrator for a Re-Plumb Claim, or accept the one-time $3,000 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. WORK AUTHORIZATION

By signing and returning this Claim Form, I accept the terms of the Settlement and authorize the Claims Administrator to schedule inspection, repairs, and/or a re-plumb of the property, as applicable.

VII. 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.

VIII. ADDITIONAL INFORMATION/DOCUMENT ATTACHMENTS

If you have any additional information which you would like us to consider in evaluating your claim, please upload that information below.

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

    IX. 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 enclose copies of all required supporting documentation.
    4. Keep a copy of the completed Claim Form and supporting documentation for your records.
    5. If you desire an acknowledgment of receipt of your Claim Form, please use a form of mailing that will provide you with a return receipt.
    6. 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.
    7. If you have any questions, contact the Settlement Administrator by calling 1-855-976-0649, by emailing info@AlabamaTexasPEXsettlement.com, or by writing to:

    PEX System Settlement
    ATTN: CLAIMS
    1650 Arch Street, Suite 2210
    Philadelphia, PA 19103

    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@AlabamaTexasPEXsettlement.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
    First Name
    Last Name
    Mailing Address
    City
    State
    Zip Code
    Home Phone
    Cell Phone
    Work Phone
    Email Address
    Signature
    Date

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