AUTHORIZATION TO PROCEED WITH WORK; I am the New Owner or Authorized Representative (herein after “Owner”) of the contracted property, address provided on form. I hereby authorized Reliant Roofing, Inc. (herein after “R/R”), a roofing company, to perform said work, and to use such labor, materials and equipment as R/R deems advisable in accordance with the original contract.

By submitting this information, I hereby agree to the original Estimate/Contract Terms and the Limited Workmanship Warranty as contracted with the Prior Owner. I hereby understand that I am responsible to forward R/R proof of property transfer within 30 days of actual date of transfer.

Owner understands and acknowledges that prices are subject to change without notice and that by accepting this work Owner provides their electronic signature for R/R to proceed with this work in accordance with any and all applicable laws specifically including, but not limited to, the Federal Electronic Signatures in Global and National Commerce Act and/or Chapter 668, F.S.

Owner understand and acknowledges that by submitting their information in the claim form, that their information is now subject to our privacy policy.