Full Name
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Company Name (If applicable)
Phone
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Email
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Approximately how many years old is your roof?
Less than 10 years old
10 to 20 years old
More than 20 years old
Do you have algae (dark streaks) or moss (green clumps) on your roof?
Yes
No
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How did you hear about us?
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WWBT - NBC 12
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