Southern Coast Roofing

Estimates

RE-ROOF ESTIMATE REQUEST FORM
Please complete the form below to receive a call to schedule a Re-roof or Repair estimate from Southern Coast Roofing.

1. What type of roof do you currently have?

Concrete Tile	Cedar Shakes
Clay Tile	Asphalt Shingles
Standing Seam Metal	Modified Bitumen

2. How many stories is your roof, is your community gated? Have you seen an adjuster yet?

3. Frequency of leakage

During all rains	Not leaking now
During driving rains only

4. Extent of leakage

Severe	Mild
Not leaking now

5. An appointment will be scheduled to meet personally with you to measure the roof, put the contract in writting and to go over the proposal with you to answer any questions.

9. Re-roof Estimate Authorization

Name:

Date:

10. Please provide your contact information below.

Contact Name:

Company:

Email:

Daytime Phone:

Evening Phone:

Address:

Address 2:

City:

State:

Zip: