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Thank you for considering Bi-State Roof Systems. Please fill out the following Roofing and Waterproofing Questionnaire for more information.

Name *

Title

Company Name *

Street Address *

Phone *

E-mail *

City *
State *
Zip *

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:
Existing application is:

Has an inspection been performed for either roofing or waterproofing?YesNo

Is the present roofing/waterproofing system under a manufacturer's warranty or guarantee?YesNo

If yes, which manufacturer?

How would you rate your roofing/waterproofing system? (10 being the best)

What type of roofing/waterproofing system do you presently have?

Comments

Current month ye@r (4 digits) day *

Bi-State Roof Systems, Inc.
600 Glover Avenue
Valley Park, Missouri 63088

Phone: 636-225-3050
Fax: 636-225-3322