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Commerical Service Request

Please take a moment to fill out the form below. A Central Roofing representative will review your request and respond shortly with more information.

* Required feild
If you do not know or the information in the required fields do not apply to you, please type n/a.


Property Name *

Bill To

Owner: *

G/C: *

Address: *

City: *

State/Zip: *

Contact: *

Email: *

Previously Listed As *

Bill To

Mgmt Co: *

Manager: *

Email: *

Address: *

City: *

Contact: *

Phone: *

Building Unit Nature of Problem*

Service Details

* Required feild

Roof Type/Manufacturer:

Type of Access/Stories:

Days/Hours of operation:

Manufacturer Warranty Confirmation: *

Number & Date Ticket Submitted
(For TPO roofs): *

Property Purchase Order:

Authority Onsite Contact: *

Onsite Contact Email: *

Onsite Contact Number: *

Notes: *


*By submitting this service request, you have entered into a contract and authorize repairs and payments for said repairs at the areas shown above and/or those requested by the designated and authorized onsite contact. Your designated contact must be authorized to approve repairs onsite at the time of the scheduled visit. Failure or refusal to approve required and/or necessary repairs to maintain the integrity of the roof while onsite can result in voided manufacturer/material/workmanship warranties as well as trip charges. Charges (trip and/or repair) will be assessed for any work not covered under the workmanship warranty. All balances (including retainage) must be paid in full for the warranty to be valid and active. You are also accepting our standard insurance and waive all rights to refuse or delay payments based on additional coverage’s, requirements, registrations, certificates, memberships, or vendor applications. Invoices are submitted via email to the email noted above. Payment is due upon receipt unless other payment term arrangements have been made prior to service with the Service Manager. A 4% fee is added for all credit card payments. An initial late fee of 30% will be assessed for any amounts not paid in full within 30 days. Lien notices will be issued on any payment outstanding after 30 days and all legal / attorney fees will be added to the balance due.