Rick's Main Roofing
Located at 26 Fitch Street,
Norwalk, CT
Telephone: (203) 838-5858
Fax: (203) 838-4949


**And don't forget our
24 hour emergency service to help you out in the worst situations!
 
   
 
Name:
 
Company:
 
Address:  
 
     
 
Apt:
 
City:
 
St:  
 
     
 
Zip:
 
Home #
 
Work#  
 
     
  Are you:  
Homeowner
 
Relative/Friend
 
Contractor
 
Real Estate Agent
 
Job Address (If different from above)
 
Address:  
City:
 
State:  
 
     
 
Main Road or Intersection (Or Landmark) Near Job:  
 
     
 
Type of Roofing (check all that apply):  
 
 
Flat  
Pitched
 
Metal
 
Slate/Tile
 
Rubber
 
Shingle Asphalt/Fiberglass
Synthetic
  Other:
 
     
 
Age of Roof:
 
Number of Layers:
 
     
 
  Is the roof currently leaking?  
Yes
 
No
  (Description)
   
 
  Job State  
Pricing/Budgeting
 
Ready to Start/Immediate
   
  Type of Roofing Desired:  
   
 
  Notes:  
   
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