Advanced Coating - Contact Us - Contractor Questionnaire

All prospective contractors and installers interested in working with our coating systems are required to complete this questionnaire. The contents of this information will be confidential and used solely to determine your firm's qualifications.

I. General Information

Business Name :		Address:
City :		State:
Zip / Postal Code :		Website:
Telephone :		E-mail :

Contact name and title :

II. Business Information

How long has your firm been in business (yrs):

Business Type:

Type of roofing your firm installs:

	Acrylic Coating		BUR
	EPDM		Aluminum Asphalt Coating
	Foam		Concrete
	Tar & Gravel		Metal
	Mod. Bit		Shingle
	Transite		Single Ply

Tile

Other

III. Business experience

Do you currently install acrylic elastomeric coatings?

If so, which brands:

In what region of the country are you interested in installing our coatings? (select all that apply)

Northeast

Southeast

Midwest

Southwest

West

Do you have more than one crew?

If so, how many and where are they:

Do you currently have a marketing program?

If so, please explain:

Have you seen an increase in the demand for elastomeric roof coatings in your market?

Completed by:

Name:		Title:
Date:

Privacy Policy
Advanced Coating Systems, Inc. will respect the confidentiality of the information relating to its individual users and visitors and the laws governing the privacy of information that apply in the country and state where the Web site is located. Information identifying a user will not be disclosed by Advanced Coating Systems, Inc. staff to anyone unless authorized by that individual. Your email address and personal details are never passed on, or sold, to 3rd parties - they are used only to supply the services requested and for statistical analysis.