Phone First Name * Last Name * Email Address * Primary Phone * What type of phone? * Home Cell Work Address * City * Zip * State * Do you have any existing damage to your roof? * No Yes (please explain) Don't worry, this will not automatically exclude you from this program Please explain What is your preferred contact method? * Phone Email Which best describes your home? * Single Story 2 Story How did you hear about this program? * Door Hanger Website Salesperson Other Who was your primary sales person? * Dan Kepple Don Kepple I don't know Terms & Conditions Free roof inspection required (If there are current repairs needed we will quote you a fair, low price to repair the roof and then accept your first months payment and begin your warranty service) Component part replacement covers the labor associated with replacing the part (customer is responsible for purchasing the new part) 90 day waiting period on leak repairs Deductible being “paid in full” assumes customer is using A2Z Roofing to re-roof the entire roof using all of the monies associated with a successful insurance claim (it does not mean that we pay the deductible for you, when we come to inspect your roof during pre-enrollment we can give you a better understanding of what we mean in regards to the deductible) Program may cancelled at any time with 2 week notification. Non-payment within 14 days of the scheduled automatic payment will result in a cancellation of the warranty program A2Z Roofing is not responsible for any damages to the interior of the home that arise from a leak under the terms of this warranty, our warranty covers the exterior of the home only By checking this box, I am acknowledging that I have read and understand the terms of this warranty program as stated above. Agreement I Agree After clicking "Submit", you will be redirected to the payment screen to complete your enrollment into our roof warranty program. Thank you for enrolling.