Warranty Request Form

Warranty Request Form

Please fill all applicable fields. Confirmation email will be sent upon submittal.
Your Name*
Your Email Address *
Submitter's Phone Number*

Area CodePhone Number
Your CUSTOM Sales Representative Email Address (Select in Dropdown)*
CUSTOM Architectural Regions - Select your region below:*

AL, AR, Caribbean,FL, GA, KS, KY, LA, MS, NC, OK, SC, TN, TXCT, DE, District of Columbia, IL, IN, IA, ME, MD, MA, MI, MN, MO, NE, NH, NJ, NY, ND, OH, PA, RI, SD, VT, VA, WV, WIID, WY, MT, CO, UT, CA, AZ, AK, WA, OR, NM, NV, HIBritish Columbia, Alberta, Saskatchewan, Manitoba, Yukon, Northwest Territories, NunavutQuebecOntarioNew Brunswick, Newfoundland, Labrador, Nova Scotia, Prince Edward IslandOther
Date - Project Awarded*

MonthDayYear
Project confirmed with CUSTOM Products (Can be approximate)
Project Name*
If the project has additional phases and requires more than one warranty, add a description after the name such as Phase 2; exterior facade; pool deck; showers; etc.... in next submission
Project Address, City/State or Province, Zip/Postal Code*
Owner Information - Contact Name, Company Name, Address, City/State or Province, Zip/Postal Code & Phone
General Contractor Information - Contact Name, Company Name, Address, City/State or Province, Zip/Postal Code & Phone
Installer/ Sub-Contractor Information - Contact Name, Company Name, Address, City/State or Province, Zip/Postal Code & Phone
Architectural Firm Information - Contact Name, Company Name, Address, City/State or Province, Zip/Postal Code & Phone
Project Size (SF / M2) *
Estimated $ Installation Value*
Approximate Date (or time-frame) of Installation*
If international project, provide value in US Dollars
Project Type*

New ConstructionRenovationMallAirportAuto DealershipRestaurantHospitalResidentialMulti-ResidentialIndustrialHotelOffice BuildingSports FacilityDairy / Food ProcessingSchoolOther
Application (Check all that apply)*

Interior FloorsInterior ShowersInterior WallsExterior FacadeExterior Roof / Deck / BalconyExterior Vehicular TrafficKitchen Floors (Epoxy Use)Floor Wear SurfacePool /Water FeatureOther
Finish Material (Check all that apply) IMPORTANT NOTE: Flooring products made of recycled materials can be unpredictable for bonding or resistance to moisture vapor emissions and may require testing. Check box below if using these products.*

Porcelain TileGauged Porcelain Tile PanelsResin-backed Gauged Porcelain Tile PanelsGlass TileNatural Stone TileTerrazzo TileQuarry TileLuxury Vinyl Tile /Luxury Vinyl PlankSheet VinylVCT (Vinyl Composition Tile)HardwoodEngineered WoodCarpetCarpet TilesRubber FlooringRECYCLED FLOORINGOther
Specialty Tile Installations - IMPORTANT NOTE: Tiles not conforming to ANSI 137.1, A137.2 or A137.3; some natural stone tile (examples: basalt, green marble, limestone, travertine); tiles with coatings; or adhered reinforcing backings may require special adhesives or rapid-setting mortars especially when installed over membranes or impervious substrates. Warranty provisions when using these materials will be enacted only with written approval by CUSTOM Technical Services and may require sample testing and mockups. Please list type below:*

No specialty tile on this projectMoisture-sensitive tileResin agglomerate tileResin-backed/reinforced natural stoneResin-backed, sheet-mounted tile or stoneBack-coated glass tileCement terrazzo tile specified with a membraneAluminum-backed tile or stoneCement-based tileMetal-based tileWood-based tileOther
Specialty Tile Installations / Mockups: Due to the unpredictable nature of some Specialty Tile products, only mockups can closely replicate results on your project. Mockups should be used to determine suitability of the entire assembly in addition to aesthetics. Please note status of mockups:*

No specialty tile on this projectMockup not performedMockup scheduledMockup results acceptablePlease contact me to assist with mockupOther
Describe Tile Type & Brands/Stone Types & Profile/Sizes or Flooring Brands/Sizes and SF
NOTE: Certain sized tiles and flooring require specialized mortars/adhesives. Provide specific information of flooring for Warranty Match submittals.
Surface Preparation Products (Check all that apply)

LevelQuik®RS (Rapid Setting) Self-Leveling UnderlaymentLevelLite® Self-Leveling UnderlaymentLevelQuik®Advanced PrimerMBP -Multi-Surface Bonding PrimerTechLevel™ 100 Self-Leveling UnderlaymentTechLevel™ 125 Self-Leveling UnderlaymentTechLevel™ 150 Self-Leveling UnderlaymentTechLevel™ XP-1 Self-Leveling UnderlaymentTechLevel™ WSF Fiber Reinforced Self-Leveling UnderlaymentTechLevel™ HPT High Performance ToppingTechLevel Lite® Self Leveling UnderlaymentTechMVC™ MoistureVapor and Alkalinity BarrierTechPrime™ A Acrylic PrimerTechPrime™ E 100%-Solids Epoxy PrimerSilk™ Patching & Finishing CompoundTechPatch™ SCTechPatch™ MP MultipurposeRapid Setting Skim Coat & Floor PatchTechPatch™ RP Ramping PatchTechPatch - TW Tilt Wall FinishingCompoundSpeedSlope®- Rapid Setting Sloping MortarQUIKRETE® Floor MudCustomFloat®Bedding MortarThick Bed Bedding MortarFast Setting Thick Bed MortarOther
Membranes (Check all that apply)

RedGard®Crack Prevention and Waterproofing MembraneRedGard®SpeedCoat Waterproofing MembraneRedGard®Uncoupling MatCBP-232 Waterproofing and Anti-Fracture MembraneCustom®9240 Waterproofing and Anti-Fracture MembraneCrack Buster®Pro Crack Prevention Mat UnderlaymentEasyMat®Tile & Stone Underlayment 5mmEasyMat®Tile & Stone Underlayment 12mmEasyMat®Tile & Stone Underlayment 3mmFractureFree®Crack Prevention MembraneOther
Tile & Stone Mortars/Adhesives (Check all that apply)

MegaLite®Crack Prevention MortarMegaLite® Rapid Setting Crack Prevention MortarProLite®Tile & Stone MortarProLite®Rapid Setting Tile & Stone MortarVersaBond® HP High Performance Large and Heavy Tile MortarVersaBond®LFT Large Format Tile MortarVersaBond® LITE Professional Large and Heavy Tile MortarVersaBond®Fortified ThinSet MortarCustomBlend® LHT Large & Heavy Tile MortarMultiSet - LFT Economical Large Format Tile MortarGlass Tile Premium Thin-Set MortarPorcelain Tile Fortified Thin-Set MortarPremiumPlus® Standard ThinSet MortarSpeedSet™ Fortified ThinSet MortarEBMLite™ EpoxyBonding MortarAcrylPro®Ceramic Tile AdhesiveT160™ CeramicTile AdhesiveOther
Note that certain mortars and adhesives are not acceptable for use in all applications. When using more than one mortar or adhesive, note which product was used where in box below.
Grouts / Sealant (Check all that apply) Please note that chemical resistant applications require epoxy grouts and certain cleaners require CEG-IG Grout. See TDS for recommendations and limitations.

Prism®Ultimate Performance® GroutPrism® Single-Component® Grout (SCG)Polyblend® HP High Performance Fine Aggregate GroutPolyblend®Plus Sanded GroutPolyblend®Plus Non-Sanded GroutPolyBlend®Sanded GroutPolyBlend® Non-Sanded GroutCEG-Lite™ 100% Solids Commercial Epoxy GroutCEG-IG 100% Solids Industrial Grade Epoxy GroutCommercial 100% Silicone SealantPolyBlend®Ceramic Tile CaulkOther
Type a question
Tile/Stone & Grout Sealers (Check all that apply)

Aqua Mix®Sealer’s Choice® GoldAqua Mix®Penetrating SealerAqua Mix®Enrich ‘N’ Seal™Aqua Mix®UltraSolv®Aqua Mix®Grout ColorantTileLab®Grout & Tile SealerTileLab®Stone Sealer & EnhancerOther
Flooring Adhesives (Check all that apply)

Vinyl™ PSAVinyl™ VCTWood™ HP4Wall BaseOther
Non-Custom Products in the Assembly
Use Project for Case Study / Marketing to be featured on CUSTOM Website?

Yes - Please contact me
Upload project attachments - Pictures, files, specifications, etc... (10 MB limit)

Browse Files

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Warranty Term Requested (Years) NOTE: Product selections will affect term lengths*

15101525LifetimeWarranty Match - Adhesives for Floorcovering. Assure exact product names are listed in fields aboveOther
Warranty Recipient- Contact Name, Company Name, Address, City/State, Zip/Postal Code & Phone number
Warranty Recipient - Email Address
Provide email address if copy is to be sent directly to reciepient
Copy of Specification Attached?

YesNo
Pre-Construction Site Inspection Completed?

YesNoTo be scheduled
Pre-Construction Site Inspection Date

MonthDayYear
Date
Products Specified by Architect/Owner
Project Notes:
Include special circumstances, etc...
Product Use Validation

Warranties require validation that the products selected in this form were used on the project and other information remained unchanged. If this is a request prior to the project's substantial completion, request an additional form below. Sign below if project is completed.
Forms (Project Not Completed at this Time) Please send me:*

A product recommendation package (includes datasheets, assembly drawing)A sample warranty formA validation form (required to enact warranty)None needed at this time
Email
example@example.com
If project is completed, sign below with mouse (or finger on touch screen):

Clear
I certify that the above project has reached substantial completion and that the CUSTOM products listed in this document were used in accordance with product Technical Data Sheets local builidng codes and industry standards. Any substitution of products without notification and approval by Custom may void any warranty. Proof of purchase will be required for warranty claims.
Date of Substantial Completion

MonthDayYear
Warranty term begins with above date
Internal Use Only

Please do not fill in any fields below
Architectural Approval Date:

MonthDayYear
Marketing Approval Date:

MonthDayYear
(When necessary)
Technical Services Approval Date:

MonthDayYear
Required
Exec Management Approval Date:

MonthDayYear
Warranty Issued Date:

MonthDayYear
Warranty #:
Should be Empty:

Warranty Request Form

Product Use Validation

Internal Use Only