Ben Hill Roofing
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COMMERCIAL
MAINTENANCE AND REPAIR
AERIAL INFRARED SCANS
RESIDENTIAL
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REQUEST A QUOTE
24/7 COMMERCIAL EMERGENCY SERVICE - CONTACT US
MAINTENANCE QUOTE
General Information
Name:
Address:
City:
State:
--select one--
Alabama
Alaska
Arizona
Arkansas
California
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Work Phone:
Fax:
Cell Phone:
Email:
Jobsite Information
Is job location same as above?
Yes
No
If not, provide job info below:
Additional Information
How did you find/hear about BHR?
Do you own the building?
Yes
No
If no, do you manage the building?
Yes
No
Age of building:
Age of roof:
Approx. square feet of roof:
Approx. budget for project:
Do you currently have roof leaks?
Yes
No
Basic access to roof is:
Services that I am interested in (please check all that apply)
New Roof
Roof Repairs ASAP
Repair/Maintenance Plan
Aerial Infrared Scan
Would you like help in preparing budgets for future roofing needs?
Yes
No
Additional Comments
Please enter any additional information you wish to add or
questions you need answered. When submitted, this form will
be reviewed by our staff. We will get in touch with you within
24 hours and respond to your questions.