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First Name

M.I.

Last Name

Address Line

City

State

Zip Code

E-mail Address

Phone

Fax

Bold = Required field

I am repairing/replacing because:

I am interested in maximizing my investment

I want a new look for my home

I am planning on selling in the near future

Not renovating now / Just curious

I am interested in replacing the entire roof:

My Entire Roof

A Section Only

Are you considering installing a different roofing material? If so, what type?

Type of current roof system:

None (New Construction)

Shingle

Metal

Other

Approximate Age of Current Roof:

Condition of Roof:

Bowed Shingles

Cracked or Missing Shingles

Curled Shingles

Dark, "Dirty-Looking" Areas

Flashing / Sheathing Decay

Slightly Worn Shingles

No Noticeable Wear

Other Problem Signs:

Siding Decay

Blistering and/or Peeling of Paint Near Roof

Interior Leaks

Leakage after Heavy Rains

Ceiling Stains or Evidence of Prior Leaks

Excessive Energy Bills

None

Type/Style of House/Building:

Square Footage:

Climate Extremes:

Heavy Snows

Heavy Ice Build-Up

Within 1/2 Mile of Ocean

Within 1/4 Mile of a Large Body of Water

Heavy Winds

This Property Is:

My Primary Residence

My Business Location

A Secondary/Vacation Residence

A Rental Owned by Me

*We use this information only for the purposes of supplying you with information pertaining to your estimate. We do not and will not supply this information to any third party.

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