Media*
Property Property*
Owner Owner Name*
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Last
Insurance
Selected Shingles
Agreement Guideline Roofing will, however, perform the scope of work approved by the insurance company for the amount of the insurance approved proceeds, with no additional costs to you, except those for OSB and your deductible. The final scope and price agreed on between the insurance company and Guideline Roofing shall become the final contract price for the insurance approved scope. You will be responsible to pay for any upgrade or additional work authorized by you that the insurance company determines is not covered within the scope of coverage provided by your insurance policy. Supplemental claims billed by Guideline Roofing that are approved by the insurance company for additional work or increase in cost become a part of the contract.
Special Instructions
Provide any additional special request items to be completed during installation such as removal of satellite dish, installation of new chimney cover, etc.
Payments Mortgage Escrow* Will the mortgage company escrow a portion of the first insurance draft?
Payment Method* If selected, ACH Bank Drafts will be collected directly from your bank account, using the routing number and account number you provide.
Write separate checks for the deductible and for the initial deposit amount calculated above, and record the check numbers, Guideline Roofing will coordinate with you for receiving the checks.
If you are waiting for your mortgage company to countersign the first draft payment from your insurance company, we will coordinate with you to pick up the checks after you have deposited the draft payment and it has cleared.
When you have received the initial escrow disbursement, you will write separate checks for the deductible and for the initial escrow amount and Guideline Roofing will coordinate with you to receive the checks.
ACH Account(s)* ACH Payment Sources* Bank Name: Bank of America, Wells Fargo, State Employees Credit Union, etc. Please spell out full name, no abbreviations.
Bank Routing Number: Enter the routing number for your bank found on your checks (not on your deposit slips).
Bank Account Number: Enter your bank account number.
For Payment : Enter “Deductible”, or “Deposit”, or “2nd Payment” as desired.
Desired Amount: Enter amount to be drafted from this account if you need to split drafts between accounts on same payment.
Signature Guideline Roofing shall hold in trust any payment from the property owner until Guideline Roofing has delivered roofing materials at the residential property site or has performed majority of the roofing work on the property. I/We agree, by signing below, to all the contract conditions, both above and below.
Notice of Conditions