Your Name:

Company Name:

E-Mail Address:

Telephone Numbers:
Home #

Work #
ext:
Mobile #
ext:
Fax Number:

Mailing Address:


Structure Address:


Nearest Cross Street:

Your relationship to the structure?
Owner/Occupant Owner/Landlord Potential Buyer Agent (for family, friend, client, etc) Other
If Other, Please Explain:

Structure Use:
Commercial Industrial Residential

Work Needed:
(hold the "Ctrl" key down while clicking all that may apply)
Repairs Maintenance Roof Modification Waterproofing (coatings,etc) Re-Cover (install new over existing) Re-Roof (remove & replace roof) Addition(s) New Construction Other
If Other, Please Explain:

Structure Height: (from the ground to the bottom of the roof)
Single Story Two Story Split Level Other
If Other, Approximate Height in Feet:

If Roof Access is Available, Please Describe:
(such as a roof hatch in a tall warehouse-style building)

Roof Pitch
Flat Almost Flat Low-Sloped Average-Sloped (typical home) Somewhat Steep Very Steep (such as an A-Frame)
or, If the Exact Pitch is known:

Type of Existing Roof System:
Built-Up (BUR or hot asphalt) Composite Shingles Metal Rolled Roofing Single Ply (PVC, EPDM, TPO, etc) Tile Torch Down (Modified Bitumen Membrane) Wood Shakes Wood Shingles Other Not Applicable (new construction) Unknown
Other Information About the Existing Roof:
(brand, color, installation method, etc.)

Number of Existing Layers:

To Whom Should We Submit This Estimate?
(If different than from above) - Include all pertinent information

Preferred Method of Submission:
E-mail Postal Mail Fax

Would You Like to Set an Appointment?
Yes (Call To Schedule) No (Just Go Look)
Other Instructions for Us:

Questions | Comments | Suggestions:

Please be assured that all of the information submitted will be used ONLY for the purpose of providing you with the free estimate(s) you have requested. You will not be added to any mailing or telemarketing lists (NO UNSOLICATED MAIL, ANNOYING PHONE CALLS, ETC.). Your privacy is important to Hoag Roofing; we would never consider selling or sharing any of your personal information with a third party.