Free Roofing Certificate PDF Form Get Document

Free Roofing Certificate PDF Form

The Roofing Certificate form is an essential document that enables residential property owners in Texas to secure a reduction in their insurance premiums. By certifying that a roof covering has been installed according to the manufacturer's specifications and meets specific impact resistance standards, homeowners can potentially save money on their insurance costs. To take advantage of this opportunity, fill out the form by clicking the button below.

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Outline

The Roofing Certificate form plays a crucial role for homeowners in Texas seeking to reduce their residential insurance premiums. This document, provided by the Texas Department of Insurance, serves as a certification that the roof covering installed on a property meets specific impact resistance standards set by Underwriters Laboratories. Homeowners must complete the form with detailed information about the roofing company, including the company name, address, and license number, as well as information about the residence and the owner. The form requires the roofing company’s authorized representative to certify that the installation was completed according to the manufacturer's specifications and to specify the classification of the roof covering, which can range from Class 1 to Class 4 based on impact resistance. Additionally, the form includes provisions regarding labeling, ensuring that the roofing materials comply with the necessary standards. Importantly, this certification does not imply any warranty from the manufacturer or installer, but it is essential for homeowners to secure potential savings on their insurance premiums. The completion of this form not only facilitates the insurance process but also emphasizes the importance of adhering to safety and quality standards in roofing installations.

Key takeaways

Filling out the Roofing Certificate form can be a straightforward process, but there are essential points to keep in mind to ensure you maximize your benefits. Here are key takeaways to consider:

  • Purpose of the Form: This certificate is designed to help homeowners secure a reduction in their residential insurance premiums.
  • Authorized Representative: Only an authorized representative from the roofing company should sign the form, ensuring that the information is accurate and valid.
  • Impact Resistance Classification: The roof covering must comply with Underwriters’ Laboratory Standard 2218, and you need to indicate the impact resistance classification, which can range from Class 1 to Class 4.
  • Labeling Requirements: Ensure that the roofing materials are properly labeled according to the specifications. This includes the manufacturer’s name, date of manufacture, and brand name.
  • Documentation: Retain a copy of the completed form for your records, and provide a second copy to your insurance company. This step is crucial for verifying your eligibility for the premium reduction.
  • Potential for Fraud: Be aware that any intentional misrepresentation on the form could be considered fraud, which carries serious consequences.
  • Contact Information: Keep the Texas Department of Insurance contact details handy in case you have questions or need assistance with the form.

By following these key points, homeowners can navigate the process of filling out the Roofing Certificate form with greater ease and confidence.

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NOTICE TO HOMEOWNER: Completion of this certificate will entitle you to a credit on your residential insurance premium. This form is solely for the purpose of enabling residential property owners to obtain a credit on their residential insurance premium and it is not to be construed as any type of express or implied warranty by the manufacturer, supplier or installer.

Roofing Installation Certification

Name of Roofing Company

Street Address

City, State, Zip

PhoneLicense # (if any)

Address of Residence (Installer must complete the following information before signing form.)

Name of Owner

 

Home Phone

 

 

Address

 

 

 

Work Phone

 

 

City, State, Zip

 

 

 

 

 

 

I,

 

 

, an authorized representative of

 

 

 

 

 

 

 

Print Name of Representative

 

 

 

 

 

 

, do hereby certify that

 

 

 

 

 

 

 

 

 

 

 

Print Name of Roofing Company

I have installed in accordance with the manufacturer's specifications on the above described residence a roof covering listed as complying with Underwriters' Laboratory Standard 2218, Impact Standard for Impact Resistance of Prepared Roof Covering Materials with an impact resistance classification of:

Class 1

Class 2

 

Class 3

Class 4

Manufacturer's Name

 

 

Brand Name

 

 

 

Year Manufactured

 

 

 

Date of Installation

 

 

 

 

 

 

 

 

 

 

 

The roof covering installed on this residence meets one of the following requirements:

The roof covering product packaging indicates the U.L. Classification under U.L. Standard 2218, the manufacturer's name, the date of manufacture, and the brand name. A label from the packaging has been supplied to the owner of the residence; or

The metal roof covering is 26 gauge or thicker material, and is installed over solid underlayment.

 

 

 

 

 

Original Signature of Roofing Company's Authorized Representative

 

Date

 

 

 

 

 

Policyholder's Signature

 

Date

 

One copy for Insurance Company

 

Second Copy to Policyholder

OFB 8350 09-12

 

 

 

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