Korellis Leak Request

Korellis Leak Request

Type of Service

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ATTENTION

Korellis no longer offers residential roofing services, as we specialize in commercial and industrial roofing only.

We apologize for the inconvenience and thank you for your understanding.

Date of Request*

Service(s) Requesting:*

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Reported by Name (first & last)*

Reported by Phone Number*

Reported by Email*

Property Name that needs Service*

Property Address Needing Service*

(including city, state, zip)

Approximate Height of building?

Roof Access?

Site Point of Contact*

Site Contact Phone Number*

Site Contact Email*

Billing Address different from property address?*

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Billing Company*

Billing Address (including city, state, zip)*

Roof Type

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Membrane Type

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Temporary / Permanent Repair

We can only apply permanent repairs on a dry roof. Would you like for us to wait until conditions allow us to make a permanent repair?

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Specific Area of Leak*

Be specific on area inside the building, ie, break room, conference room, etc.

Reported Problem*

Is this a Safety Hazard?

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Is Production being impacted?

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PO #

Response Time

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Provide photo if you can

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