COMPLETION FORM
Full Name
Property Address
Phone Number
Email Address
Insurance Company
Claim
Mortgage/Lien Holder
Phone
Description of  work
Unit
Quantity

Rubinsky Roofing, LLC will send the confirmation to the Customer’s insurance company that all work agreed on has been completed with the detail on what work was done so the proper funds can be mailed to the Customer. As soon as payment is received, it is due to Rubinsky Roofing, LLC.

 

The responsibility to ensure the funds are released and received in a timely manner are on the Customer. Rubinsky Roofing, LLC will assist in the process but is not responsible to get the funds released. 

Customer will owe a balance of

+ Supplements within 30 days from signing this document.

By signing below the customer agrees to the terms on this document.

 CUSTOMER SIGNATURE 
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CPE ROOFING REPRESENTITIVE SIGNATURE
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