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Installer Application

Installer Application

For a better user experience, please fill out this form on a desktop computer.

Company's Name

Name of Contact

Phone number

Website URL

Email

Address

Point of Contact

Areas of Coverage

Roofing Types (must specify years of experience in trades you know):

Asphalt shingle

Asphalt shingle

SBS Flat

SBS Flat

EPDM

EPDM

TPO

TPO

Years of Asphalt shingle Experience

Years of SBS Flat Experience

Years of EPDM Experience

Years of TPO Experience

Slate

Slate

Cedar

Cedar

Other

Other

Other Roofing Type

Years of Slate Experience

Years of Cedar Experience

Years of Other Experience

Have you worked on:

New Construction?:

Yes No

If you answered YES, write years of experience:

Reroofing?

Yes No

If you answered YES, write years of experience:

Do you use sub-contractors?:

Yes No

Can you install? (must specify years of experience):

Gutters

Gutters

Trim

Trim

Soffit

Soffit

Fascia capping

Fascia capping

Years of Gutter experience

Years of Trim experience

Years of Soffit experience

Years of Fascia capping experience

Fascia board replacement

Fascia board replacement

Years of Fascia board replacement experience

Average crew size (# of people):

Squares completed approx, per day, per job:

Do you have?

Dump Trucks Dumpsters

INSURANCE PROTECTION

Do you carry?

Carrier - Liability Workers Compensation

3 Trade References

1. Bank Reference

Name

Company’s Name

Phone number

Address

2. Material Supplier

Name

Company’s Name

Phone number

Address

3. Other

Name

Company’s Name

Phone number

Address

3 Homeowner References

Homeowner (1)

Name

Phone number

Homeowner’s Address

Homeowner (2)

Name

Phone number

Homeowner’s Address

Homeowner (3)

Name

Phone number

Homeowner’s Address

Office Info

135 Dale St. West Babylon,
NY 11704.

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