Cotect Roofing - Inspections/Repair Form

Owner/Customer Full Name*

First NameLast Name

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Building Type*

Number of Floors/Stories*

Age of Roof*

Work to be performed

Bill To*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Choose a Service:*

Emergency Repair - Deposit: $1,000.00 + 3% Processing Fee // Rates: $75.00 per hour per man (2 man crew) (Minimum 1 day) plus cost of materials. Minimum service cost $1,000.00Roof Inspection [Returning Customer] - $250 + 3% Processing FeeRoof Inspection [New Customer] - $400 + 3% Processing FeeCommercial Inspections [A team member will be reaching out to you shortly]

Disclaimers:

Deposit is non-refundable unless canceled prior to dispatch of technician(s).

Terms of Service Agreement:
I am the Owner or Authorized Representative (herein after“ Owner”) of the Jobsite Address at which work is to be done. I hereby authorize Cotect Roofing, LLC (herein after "Cotect") to perform said work, and to use such labor, materials and equipment as Cotect deems advisable.
All repairs performed by Cotect are based on our visual inspection of the area reported problem (please attach photos of all visible issues). Cotect will only perform a visual inspection based on the photos provided, and cannot guarantee additional problems will not be discovered once repairs commence.
I hereby authorize Cotect to perform the work in accordance with the terms and conditions as set forth above, and represent that I am empowered to authorize service on the premises listed here and I agree to pay according to the Terms.

I understand and acknowledge that by accepting this work I am providing my electronic signature for Cotect Roofing, LLC to proceed with this work in accordance with any and all applicable laws specifically including, but not limited to, the Federal Electronic Signatures in Global and National Commerce Act and / or Chapter 668, Florida Statutes.

Returning Customers:
For the purpose of reinstating your warranty after a storm and/or yearly check-up

Disclaimers:

In order to maintain or receive warranty, the roof may be subject to repairs and/or maintenance. Inspection does not guarantee the roof will be eligible for warranty due to excessive deterioration and/or damage beyond repair. Inspection price is non-refundable.

New Customers:
For the purpose of getting warranty from us if we didn't do the roof, it is out of warranty, and/or older roof

Disclaimers:

In order to maintain or receive warranty, the roof may be subject to repairs and/or maintenance. Inspection does not guarantee the roof will be eligible for warranty due to excessive deterioration and/or damage beyond repair. Inspection price is non-refundable.

Please verify that you are human*