PIN Form

Applicator / Company Information

Applicator / Company Mailing Address

Onsite Personnel Information

First Name

Last Name

Production Manager’s Cell Number

Project Information

Anticipated Project Start Date ^*

Anticipated Project Completion Date ^*

Building ID/Project Name ^*

Building Owner ^*

Building Owner's Representative

First Name ^*

Building Owner's Representative

Last Name ^*

Building Owner's Representative Phone Number ^*

Building Owner's Representative Email ^*

Project Address

City

State

Zip Code

Is the Building Owner's Address the same as the Project Address?YesNo

Warranty Request Information

Project Type

Roof CoatingsDecking & Waterproofing (DWP)

Requested Warranty Term (# of Years)

Application Area in Sq Ft.

Application Area's Minimum Slope

Substrate Type

Core Results

WetDry

Will Bleed Trap be Applied?

YesNo

Will Primer be Applied?

YesNo

What GRP products are being Applied?

ACKNOWLEDGMENT

By Submitting this form, I certify that the information entered is correct and accurate to the best of my knowledge. Determining the integrity of the substrate and acceptability of intended application area preparation and choice of coating products is the sole responsibility of the contracted installer. I further understand that the information I provide will be used by Guardian Roof Polymers Inc. to determine whether this proposed application meets GRP technical requirements, and that GRP is under no obligation to issue a warranty until the proposed application is approved and the project passes a final inspection by a GRP technical representative.