Application for Chemical Resistant MATERIAL & LABOR Warranty


All fields with a red asterisk are required.

CONTACT INFORMATION

Enter name of project

*No warranties are issued on Underseal® residential projects.
Project Address

All fields must be completed.


Enter Owner Name

Owner Address

All fields must be completed.


Enter Firm Name

Installer Address

All fields must be completed.


Enter Firm Name

Architect / Engineer Address

All fields must be completed.


Enter Firm Name. If there was a consultant on this project, all fields must be completed. If no consultant, enter "N'A"

Consultant Address

If there was a consultant on this project, all fields must be completed.


Enter Firm Name

General Contractor Address

Enter Firm Name

Distributor Address


MEMBRANES & AMOUNTS OF MATERIALS USED - ULTRA CRM™
Chemical Resistant Sheet-Applied Waterproofing - ULTRA CRM™
ULTRA CRM™
ProductApplication TypeSquare Feet

ACCESSORIES USED WITH ULTRA CRM™
CHEMICAL RESISTANT ADHESIVES, SEALANT, DETAILING
ProductQuantity of Unit
OTHER SEALANTS, ADHESIVES, DETAILING
ProductQuantity of Unit
DRAINAGE
ProductSquare Feet
TAPES
ProductLinear Feet
BOOTS
Product

If product that was applied is not list above, please list the Name & Quantity Used.


SURFACES & SUBSTRATES

Select the surface and substrate that the system was applied to.

Surface/Substrate of Ultra CRM™ Application

If "Other" was selected above, please enter the surface/substrate of the applied product(s)


Enter any additional information of system application that may be helpful for our review of the warranty request.



MEMBRANES & AMOUNTS OF MATERIALS USED - UNDERSEAL® CRM™
Chemical Resistant Sheet-Applied Waterproofing - UNDERSEAL® CRM™
UNDERSEAL® CRM™
ProductApplication DirectionApplication TypeSquare Feet

ACCESSORIES USED WITH UNDERSEAL® CRM™
CHEMICAL RESISTANT ADHESIVES, SEALANT, DETAILING
ProductQuantity of Unit
DRAINAGE

All warranties require that drainage board (if used) MUST be Polyguard brand.

ProductSquare Feet
TAPES
ProductLinear Feet

If product that was applied is not list above, please list the Name & Quantity Used.


SURFACES & SUBSTRATES

Select the surface and substrate that the system was applied to.

Surface/Substrate of Underseal® CRM™ Application

If "Other" was selected above, please enter the surface/substrate of the applied product(s)


Enter any additional information of system application that may be helpful for our review of the warranty request.



Enter the date that the product installation was completed. This date is REQUIRED.

Enter the substantial completion date here ONLY if the specification states such.

A copy of the Project Specification is REQUIRED. Please upload your file here in Adobe PDF or Microsoft Word format.

Extended Material Warranties must have been pre-approved prior to the project start. Please include a copy of the approved Warranty Pre-Registration that you received from Polyguard showing your Pre-Registration Number. Please upload your file here in Adobe PDF format only.

Please enter the Warranty Pre-Registration Number you received from Polyguard.

Enter the term (# of years) of warranty you are requesting/were pre-approved for. This term MUST match the term specified in the Project Specification.

This application is only valid for Chemical Resistant Material & Labor warranties. Other warranties are available; please refer to our website for additional information.

Enter the email address of where you want the approved warranty sent to.


PRODUCT CERTIFICATION

Enter the name of the person completing this form.

Signature of person completing/submitting this application.

Your browser does not support the Signature field

Any missing information or incomplete application will delay processing the request. Incomplete applications will be denied and require resubmission. Please allow Polyguard 14 business days to process your completed warranty application.
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