Printable Roofing Certificate Form

When filling out and using the Roofing Certificate form, homeowners should keep the following key points in mind:

• Purpose of the Form: The Roofing Certificate is designed to help homeowners secure a reduction in their residential insurance premiums.
• Certification Limitations: This form does not serve as a warranty by the manufacturer, supplier, or installer.
• Required Information: Homeowners must provide specific details about the roofing company, including its name, address, and license number.
• Installer Information: The installer must complete personal details, including the homeowner's name and contact information.
• Impact Resistance Classification: The roof covering must comply with Underwriters’ Laboratory Standard 2218, indicating its impact resistance classification.
• Labeling Requirements: The roofing materials must be labeled according to U.L. Standard 2218, including the manufacturer’s name and date of manufacture.
• Documentation: Homeowners should receive a label from the packaging or confirmation that each individual roofing component is properly labeled.
• Signature Requirement: An authorized representative from the roofing company must sign the form, certifying the installation details.
• Submission Copies: Homeowners must retain one copy of the form, while another copy should be submitted to the insurance company.
• Fraud Warning: Any intentional misrepresentation on the form can be considered fraud, which carries serious consequences.

By following these guidelines, homeowners can effectively complete the Roofing Certificate form and take advantage of potential insurance savings.

Roofing Certificate - Usage Instruction

Completing the Roofing Certificate form is essential for homeowners seeking a reduction in their residential insurance premiums. After filling out this form, it must be submitted to the appropriate insurance company. The following steps will guide you through the process of completing the form accurately.

1. Begin by entering the Name of Roofing Company at the top of the form.
2. Fill in the Street Address, City, County, and Zip Code of the roofing company.
3. Provide the Phone number and License Number (if applicable) of the roofing company.
4. Next, fill out the Address of Residence where the roofing work was completed.
5. Complete the Name of Owner, Home Phone, Office Phone, City, County, and Zip Code fields for the homeowner.
6. In the certification section, the authorized representative of the roofing company must write their name in the space provided.
7. Indicate the impact resistance Classification of the roof covering by checking the appropriate box: Class 1, Class 2, Class 3, or Class 4.
8. Fill in the Manufacturers’ Name, Brand Name, and Year Manufactured.
9. Provide the Date of Installation of the roof covering.
10. Check one of the two labeling options provided, ensuring that the correct information about the roof covering is selected.
11. Finally, the authorized representative must sign and date the form in the designated area.

Once completed, ensure that one copy of the form is retained by the homeowner and another is sent to the insurance company. Accurate completion of this form is crucial, as any misrepresentation could be considered fraud.