Application for MATERIAL ONLY Warranty (Up to 5 Years)

Page 1

Please complete all 3 pages and be sure to click on the "SUBMIT" button at the bottom of the last page.


All fields with a red asterisk are required.

CONTACT INFORMATION

Enter name of project

All fields must be completed.

Project Address

Enter Owner Name

All fields must be completed.

Owner Address

Enter Firm Name

All fields must be completed.

Installer Address

Enter Firm Name

All fields must be completed.

Architect / Engineer Address

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

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

Consultant Address

Enter Firm Name

General Contractor Address

Enter Firm Name

Distributor Address

Please complete all 3 pages and be sure to click on the "SUBMIT" button at the bottom of the last page.

Page 2

Please complete all 3 pages and be sure to click on the "SUBMIT" button at the bottom of the last page.


MEMBRANES & AMOUNTS OF MATERIALS USED

Please complete a row for each product applied. Batch Number(s) are required for all fluid-applied products.

ProductApplication TypeBatch Number(s)Square Feet
Fluid-Applied Air Barriers

Complete this section for ONLY 36" membranes

ProductApplication TypeSizeSquare Feet
Sheet-Applied Air Barriers

Complete this section for any/all cut sizes 6"to 24". Only the UV named products are approved for Roofing Underlayment & Planter/Roof Garden applications.

ProductApplication TypeSizeSquare Feet
Sheet-Applied Flashings
AIR BARRIERS & FLASHINGS

Please complete a row for each product applied. Batch Number(s) are required for all fluid-applied products.

ProductApplication TypeBatch Number(s)Square Feet
Fluid-Applied Waterproofing

ProductApplication DirectionApplication TypeSquare Feet
Sheet-Applied Waterproofing: PRE-APPLIED

ProductApplication DirectionApplication TypeSquare Feet
Sheet-Applied Waterproofing: POST-APPLIED

ProductApplication TypeSquare Feet
Sheet-Applied Waterproofing: BALCONY

ProductApplication TypeSquare Feet
Specialty Sheet Membranes
WATERPROOFING

Please complete all 3 pages and be sure to click on the "SUBMIT" button at the bottom of the last page.

Page 3

Please complete all 3 pages and be sure to click on the "SUBMIT" button at the bottom of this page.


DRAINAGE
If the project specification requires drainage/protection, then drainage/protection board must be installed. If Polyguard brand was not installed, please complete the "OTHER" section below.
Product
POLYFLOW®

Product
TOTALFLOW™

Please complete this section if drainage/protection board installed was not Polyguard brand.

Product Brand NameProduct Name
OTHER

ACCESSORIES & AMOUNTS USED
ProductQuantity of Unit(s)
PRIMERS, SEALANTS, ADHESIVES, DETAILING

ProductLinear Feet
TAPES

ProductQuantity of Unit
MISCELLANEOUS

Select the surface and substrate that the products were applied to.

Surface/Substrate
SURFACES & SUBSTRATES

Please use this area for any information not requested on this form, such as drainage board by others used or specific info to help process the warranty. Any missing information will delay the process.


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.

Select the term of warranty you are requesting. This term MUST match the term specified in the Project Specification.

This application is only valid for a Material Only of 1 to 5 years. 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.

Be sure to click on the "SUBMIT" button or your application will not be sent to us.

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