CROWN ROOFING & CONSTRUCTION INQUIRY FORM

CLIENT INFORMATION

PLEASE COMPLETE FOR SERVICE OR INQUIRIES
Client Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Preferred method of contact
ADDRESS OF PROPERTY TO BE INSPECTED / QUOTED

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you own this property?
If you responded NO, please specify / explain & provide the owners contact information here:
Inquiry Type
PERMISSION TO INSPECT: I give permission to Crown Roofing & Construction to inspect the property listed above which may include climbing on the roof (roof inspections only.)
Please be sure to disclose any potential safety issues* that our inspectors should prepare for while inspecting the property, if applicable. *This would include leaks on the roof that may have caused rot, any known or potential structural issues, electrical or environmental hazards, etc.) Thank you.
Questions you have for us.
STORM DAMAGE: Please describe if this was wind damage (missing shingles, siding blown off AND/OR an active leak. Please note if a tree is involved (on the structure/ coming through the house.) Note any known safety issues if applicable (down wires etc.) If you were referred by your insurance company, please note. If you would like us to submit our photos/ inspection/ proposal to your insurance company please request the provider disclaimer, providing us the claim number to submit our documentation.
Emergency Tarp: (This is a temporary protective measure to prevent further damage until permanent repairs can be completed.)
Should be Empty:

CLIENT INFORMATION