Agreement Form

Agreement for Repairs

Proposal Submitted To:
Combat Consultant:
Client Source:
Type of Loss:
Claim #:
Policy #:
Daytime Phone:
Nighttime Phone:

Exterior Repairs



ISO Board
Pick One
Shingle Color:
Roof Labor Warranty in years
Paint Roof Vent Stacks Color:
Ridge Type
Ridge Vent size in ft.
# of Skylights:
# of Skytubes:


Gutter in Feet
Downspouts in Feet


Power wash and Stain Fence - Color
Repair Fence in Feet
Replace Fence in Feet


Comb A/C # Unit
A/C Top # Unit
A/C Condenser # Unit


Specify Area:


Screen #:
Beading #:
Cracked Glass #:
Windows #

Garage Door

Garage Doors #:
Door Openers #:
Owner Initials
Additional Owner Initials

Additional Damage

Combat Roofing noted the following areas of damage that were not included in your insurer's repair estimate:
Combat Roofing will work to reach agreement on the price and scope for this additional work. If the insurer declines payment, the additional work will not be performed unless you agree to pay, at your own expense, for the portion of the repairs that were declined.

Bid Price

Due to the unique nature of repairs related to insurance claims, this contract does not include an explicit price because the final scope has not been agreed upon with the insurer. Reaching agreement on the full scope of repairs involves considerable time on Combat Roofing's part; we will not proceed with this phase unless you agree to allow us to do the work once the scope is agreed upon. By signing this agreement, you authorize Combat Roofing to reach agreement on the price and scope of repairs on your behalf. Combat Roofing agrees to bid the work using the primary insurance industry pricing database (Xactimate) based on the scope of work agreed upon with your insurer, including general contractor markup at customary insurance industry rates (20% markup on Xactimate line items). Any substantial additions or deductions to the scope of work will be handled by written construction change orders. All supplementals will be paid to Combat Roofing at the time when final payment is due. If the insurer indicates that any line item of the work not covered at full replacement cost (RCV), the client will be responsible for the difference between the replacement cost and insurance coverage. To the extent we are informed of those items by the insurer in a timely manner, we will inform you, and you can decide whether you want to proceed with the work and pay the portion of the costs not covered by your insurer.


You agree to make payments on the following schedule (date or construction milestones). You agree to have Combat Roofings named, along with you, on all payments from the insurer that are related to Combat Roofing's work and that are issued after this contract is signed. If a portion of the insurer's payment is held by a mortgage company, you further agree to have Combat Roofings named, along with you, on all payments from the mortgage company related to Combat Roofing's work. By using joint checks on the payments, neither party can cash the joint checks without the other party's consent, which protects bpth parties. Failure to make timely payments may delay the work and/or cause collection actions.
Amount Due
1. Deposit
Materials initially arrive on site
Deposit Due
2. Progress Payment #1
3. Progress Payment #2
4. Final Payment
After Final Completion

Acceptance of Terms

By signing below, property owner(s) agree(s) to all the contract conditions, including the terms and conditions that are printed on the backs of this contract. If you change your mind, and do not want to proceed with this agreement, you have three (3) business days to terminate this agreement without any consequences.
Owner Electronic Signature
Additional Owner Electronic Signature