Chemical Resistant Warranty Pre-Registration Application

Page 1

Page 2

Chemical Resistant Warranty Pre-Registration Application

Please complete both pages and be sure to click on the "SUBMIT" button at the bottom of the last page.

PLEASE READ

* Complete this form PRIOR to the start of the project.

* Complete Pages 1-2.

* Fields with a red asterisk are required to be completed.

Today's Date

Date

PROJECT

Enter name of project

Project Address

All fields must be completed.

Address 1

City

ZIP / Postal Code

State / Province

OWNER

Enter Owner Name

Owner Address

All fields must be completed.

Address 1

City

ZIP / Postal Code

State / Province

Owner Contact Name

Owner Contact Email

Owner Contact Phone Number

INSTALLER

Enter Firm Name

Installer Address

All fields must be completed.

Address 1

City

ZIP / Postal Code

State / Province

Installer Contact Name

Installer Contact Email

Installer Contact Phone Number

Installers Bonding Percentage (%) Rate

Preferred Date for Product Training

Date

ARCHITECT / ENGINEER

Enter Firm Name

Architect / Engineer Address

All fields must be completed.

Address 1

City

ZIP / Postal Code

State / Province

Architect / Engineer Contact Name

Architect / Engineer Contact Email

Architect / Engineer Contact Phone Number

Consultant

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

Consultant Address

Address 1

City

ZIP / Postal Code

State / Province

Consultant Contact Name

Consultant Contact Email

Consultant Contact Phone Number

GENERAL CONTRACTOR

Enter Firm Name

General Contractor Address

Address 1

City

ZIP / Postal Code

State / Province

General Contractor Contact Name

General Contractor Contact Email

General Contractor Contact Phone Number

Please complete both pages and be sure to click on the "SUBMIT" button at the bottom of the last page.

Please complete both pages and be sure to click on the "SUBMIT" button at the bottom of this page.

Project Expected Start Date

Date

Warranty Requesting

Polyguard's Fee per Square Feet (SF) applies to all of the following warranties: 15 Year Material Only, 10 Year Material & Labor, 15 Year Material & Labor. Contact [email protected] for this project fee rate.

Term/Type

Project Specification Requirements

Installation Date

Date

Substantial Completion Date

Enter the estimated substantial completion date.

Date

Warranty Need Per Specification

By Date

THIS SECTION IS FOR USE BY POLYGUARD ONLY

Exceptions/Waiver Approvals can only be approved by Architectural Director of Tech Services & Product Management

Warranty Exception of Requirements

Material & Labor fee waived

Documents Required To Accompany This Form

Specification

A copy of the Specification is required. Please upload a single PDF or Word file only. (Specification must include sections listing Warranty Requirements (i.e. terms) and all products specified)

Project Plans / CAD Details

A copy of the Project Plans / CAD Details are required. Please upload a single PDF file only.

Ultra CRM™ System

Ultra CRM™

Add all the Ultra CRM™ System products you plan to use on this project.

Product	SF

Ultra CRM™ System Accessories

Add all the Ultra® CRM™ System products you plan to use on this project.

Product	SF