BUILDER AND DEALER SERVICE REQUEST FORM Step 1 of 2 - Contact Info 0% Contact InfoI am a dealer or builder (select one)BuilderDealerBusiness Name*Requestor’s name*Phone Number**Select *HomeMobileBusinessPhone Number 2 (Additional)SelectHomeMobileBusinessPhone Number 3 (Additional)SelectHomeMobileBusinessEmail Address* Home Owner InformationFull Name of Homeowner or Site Contact*Phone NumberAddress of Home (no p.o. boxes)*City*Province*Postal Code* Contact Info Project Details Success Project DetailsThe more information provided will ensure we can process your request as quickly as possible.Under Construction?*YesNoOccupied?*YesNoProduct Installed?*YesNoPossession Date if applicable (MM/YY)Chargeable?*YesNoPO#Order/Quote#Line #Room Location(s)Upload AttachmentsAccepted file types: jpg, gif, png, pdf, jpeg.Providing photographs, will help us understand your issue and will help ensure a faster diagnostic and response.Description of Service NeededAdditional InformationWe care about the safety of our customers and employees. Please identify any safety concerns we should be aware of as this can help ensure your service appointment goes smoothly. (i.e. second story, steep slope, furniture restricting access, basement walkout, etc.)Safety & Access Concerns Click the arrows below to scroll through reference imagery.