Please copy and paste the link below into a web browser to use our new request form!
"https://clienthub.getjobber.com/client_hubs/4212ffee-1a1a-4b64-8be1-7b376c900005/public/work_request/new?source=geraldformredirect"
Riviera Dunes
Estimate Request Form
Priority Customer
Estimate Request Form
Nextdoor Customer
Estimate Request Form
Customer Type
Residential
Business
Realtor / Property Manager
Storm (Internal Use)
Hide
Show Repair Options
Yes
**Storm Mode -- Repair
**
Name of Repair Tech.
Repair Notes:
Repair Photo/File Upload
Browse Files
Drag and drop files here
Choose a file
Pictures or PDF Documents
Cancel
of
**Storm Mode -- Estimate
**
Name of Storm Rep.
Estimated Cost $$
Estimate Photo/File Upload
Browse Files
Drag and drop files here
Choose a file
Pictures or PDF Documents
Cancel
of
Business Name
Primary Contact
*
First Name
Last Name
E-mail Address (Primary Contact)
*
(This is where we will send the Estimate)
Phone Number (Primary Contact)
*
Work Order #
(Optional)
Contact Tenant/Owner before arriving?
Yes
No
Tenant or On-site Contact
First
Last Name
Phone Number of Tenant or On-site Contact
Address
*
Second Address
*
Add Second Address
Please choose the categories that best describe your roof damage or request:
*
Free Inspection
Replacement Estimate
Leak
Tune-Up
Fascia
Tile Damage
Soffits
Shingle Damage
Other
What type(s) of roof do you currently have?
Shingle
Tile
5V Metal
Standing Seam Metal
Flat Roof (Modified Bitumen, TPO, etc.)
Other
What type(s) of roof replacement are you considering?
Shingle
5V Metal
Standing Seam Metal
Flat Roof (Modified Bitumen, TPO, etc.)
Other
.Which type of Roof Replacement?
Shingle, 5V Metal, Standing Seam Metal, Membrane, etc.
.Which type of roof do you have now?
Tile, Shingle, Metal
Building Height / Number of Stories
(Optional)
Estimated Age of Roof?
(Years - Optional)
Description: (Optional)
Water spot in bathroom, Area of Shingle/Tile Damage, etc.
Internal Notes
Double layer of shingles, old / atypical construction, etc.
Internal Notes
Tile Color? (Optional)
Shingle Color? (Optional)
Estimated number affected? (Optional)
Upload damage photos or inspection reports: (Optional)
Browse Files
Drag and drop files here
Choose a file
Pictures or PDF Documents
Cancel
of
How did you hear about us?
(Referred By)
Pre-Fill Option
Yes
Yes 2
Yes 3
Riv
Priority Customer
Yes
Nextdoor
Submit
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