About Us
Services
Projects
Employees
FAQ
Roof Facts
Contact Us
Roofing / Waterproofing Questionnaire
Please fill out the following as accurately as possible
Approximate age of existing roofing system in years.
Approximate age of existing waterproofing system years.
Approximately how long has it been since problem areas were inspected?
Approximate square footage of roofing / waterproofing system.
Existing application is composed of:
Bitumen
Membrane
Other
Existing application is:
Horizontal
Vertical
Has an inspection been performed for either roofing or waterproofing?
Yes
No
Is the present roofing/waterproofing system under a manufacturer's warranty or guarantee?
Yes
No
If yes, which manufacturer
How would you rate your roofing/waterproofing system? (Use 1-10 with 10 being the best).
1
2
3
4
5
6
7
8
9
10
What type of roofing / waterproofing system do you presently have?
Composition Built-Up Roofing
Single Ply
Coating
Other
Unknown
Name
Title
Company Name
Street Address
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
Phone
Fax
Email
©2008 Bi-State Roof Systems, Inc.