Roof Repair Form Customer & Billing information Name * First Name Last Name Company Name * Address * Contact Email * Billing Email (if applicable) Phone Number * (###) ### #### Job information Job Name * Job Location * Site Contact Name * First Name Last Name Site Contact Phone Number * (###) ### #### Is there a PO Required * Yes No Did we install the roof? * Yes No Under warranty with any other company? * Yes No What type of service are you requesting: * Charged Inspection with Report. No work will be performed. Evaluation only. Repair Bid for large repair or partial replacement Service Call to inspect and repair any leaks Snow Removal Warranty Inspection Other What type of roof do you have? * BUR (Built-Up Roofing) EPDM Metal PVC Shingles Tile Torched Down, Modified Bitumen or Rolled Roofing TPO Additional Information Acknowledgments * - All Warranty inspection will be charged services call until proven otherwise. If we installed roof we will evaluate. If we are inspecting roof for third party, it will be billed to either customer or third party. - We send a minimum of two tech for safety purposes. - We charge Drive time to and from our location to job site. I agree Digital Signature * Please type your full name to acknowledge and agree. This will serve as your official signature. Signature Date * MM DD YYYY Thank you for submitting your application. If you do not receive call from us, please follow up in person or via phone for update on your application. All potential new hires are required to pass drug testing and safety prior to being hired.
