Roofing Certificate Form PDF Details

Roofing is an essential part of many construction projects, so having qualified and experienced roofers is key to completing a successful job. To ensure that the correct technicians are being hired to complete the project correctly, it’s important for employers to obtain a Roofing Certificate Form from their potential employees. This document provides proof of the employee's qualifications and helps guarantee proper operation on any type of roof system. In this blog post, we discuss how employers can take advantage of obtaining and implementing a Powerful Roofing Certificate Form in order to make sure they hire only reliable workers who have been trained in working with roof systems safely:

QuestionAnswer
Form NameRoofing Certificate Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescertificate of completion for roof, roofing installation certification form, class 4 certificate, roofing certificate of completion

Form Preview Example

Texas Department of Insurance

Property and Casualty Section – Personal and Commercial Lines Office

Mail Code 104-PC, 333 Guadalupe ｺ P. O. Box 149104, Austin, Texas 78714-9104 512-305-6711 telephone ｺ 512-490-1014 fax ｺ www.tdi.texas.gov

ROOFING INSTALLATION INFORMATION AND CERTIFICATION FOR REDUCTION IN RESIDENTIAL INSURANCE PREMIUMS

NOTICE TO HOMEOWNER. Completion of this certificate will entitle you to a reduction in your residential insurance premium. This certification form is solely for the purpose of enabling residential property owners to obtain a reduction in their residential insurance premium and it is not to be construed as any type of express or implied warranty by the manufacturer, supplier, or installer.

Name of Roofing Company:

Street Address:

City:

 

County:

 

Zip Code:

 

Phone:

 

License Number (if any):

 

 

 

Address of Residence (Installer must complete the following information before signing form)

Name of Owner:

 

 

 

Home Phone:

 

Address:

 

 

 

 

Office Phone:

 

City:

 

 

County:

 

 

 

Zip Code:

 

I,

 

 

 

 

 

 

 

, an authorized representative of

 

 

 

 

 

 

 

 

roofing company, do hereby certify that

I have installed in accordance with the manufacturer’s specifications on the above described residence a roof covering listed as complying with Underwriters’ Laboratory Standard 2218, Impact Standard for Impact Resistance of Prepared Roof Covering Materials, with an impact resistance Classification of:

Class 1

Manufacturers’ Name:

Brand Name:

Year Manufactured:

Labeling of Products:

 

 

Class 2

 

 

 

 

Class

3

 

 

 

 

Class

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Installation:

The roof covering installed on the above described residence bears the following label:

CHECK ONE BELOW

The roof covering product packaging indicates the U.L. classification under U.L. Standard 2218, the manufacturer’s name, the date of manufacture, and the brand name. A label from the packaging has been supplied to the owner of the residence.

Each individual shingle, tile, shake, panel, sheet, etc. of roof covering is separately labeled with the U.L. Standard 2218 classification and with the manufacturer’s name, the date of manufacture, and brand name.

NOTE:

After January 1, 1999, all individual shingles, tiles, shakes, panels, sheets, etc. must be labeled

 

with the information outlined above.

 

 

 

 

 

 

 

Original Signature of Roofing Company’s Authorized Representative

 

 

Date

ONE COPY TO BE RETAINED BY HOMEOWNER

SECOND COPY TO INSURANCE COMPANY

Any intentional misrepresentation relating to the completion or presentation of this form constitutes fraud.

PC068 Rev. 10/04

Page 1 of 1

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Step # 1 of filling out certificate of completion roofing

2. Once your current task is complete, take the next step – fill out all of these fields - Manufacturers Name Brand Name Year, The roof covering installed on the, Date of Installation, NOTE, The roof covering product, Original Signature of Roofing, Date, ONE COPY TO BE RETAINED BY, SECOND COPY TO INSURANCE COMPANY, Any intentional misrepresentation, PC Rev, and Page of with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Date of Installation, Any intentional misrepresentation, and ONE COPY TO BE RETAINED BY in certificate of completion roofing

It is possible to make an error when filling in the Date of Installation, consequently be sure to go through it again before you'll send it in.

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