EIC Customer Worksheet

• Please fill out all required fields below and add any comments prior to submitting.  Thank you.

  First Name
  Last Name
  Street Address
  City
  Zip
  Work Phone
  Cell Phone
  Home Phone
  FAX
  E-mail

Type of home: Ranch 1 story Split level 2 story Bungalow Other

Estimated Start Date: ASAP 2 weeks 1 month 2 months 3 months 6 months

Project type: Residential Commercial

Items to look at for estimate.... re-roof   windows metal (roof)   seamless gutters   decks shingled (roof)   fascia / soffit   porches       siding   new construction

Feel free to share any additional comments below: