The Texas PC068 form is a certification designed for homeowners to secure a reduction in their residential insurance premiums by documenting the installation of compliant roofing materials. This form ensures that the roofing installation meets specific standards, providing peace of mind to both homeowners and insurance providers. By completing this certification, homeowners can potentially save money while ensuring their property is well-protected.
The Texas PC068 form serves a crucial role for homeowners looking to reduce their residential insurance premiums through proper roofing installation. This certification form is specifically designed for residential property owners who have had roofing materials installed that meet certain impact resistance standards. By completing the form, homeowners can provide their insurance companies with the necessary documentation to qualify for a premium reduction. The form requires detailed information about the roofing company, including its name, address, and license number, as well as specifics about the roofing materials used, such as the manufacturer's name, brand, and impact resistance classification. Additionally, the form emphasizes that it does not serve as a warranty from the roofing company, but rather as a certification of compliance with established standards. Homeowners should ensure that their roofing company fills out the form accurately, as any misrepresentation can be considered fraudulent. Ultimately, the Texas PC068 form is an essential tool for homeowners seeking financial relief through insurance premium reductions while ensuring that their roofing installations meet required safety standards.
PC068 | 0423
Impact-Resistant Roofing Installation Form
Notice to Homeowner
This form can show that a property has impact-resistant roofing. Some insurance companies may offer an insurance premium discount for buildings with impact-resistant roofing. This form is not to be construed as any type of express or implied warranty by the manufacturer, supplier, or installer. Property owners should keep the original and send a copy to their insurance company.
Roofing Company Information
Name
Address
City
State
ZIP
Phone
Property Information
Manufacturer Information
Manufacturers’ name
Brand name
Year manufactured
Installation date
Labeling of products - the roof covering installed on the property listed above has the following labeling. Read the statement below and mark the checkbox if true:
The roof covering product packaging indicates the U.L. classification under U.L. Standard 2218, the manufacturer’s name, the date of manufacture, and the brand name. A label from the packaging was given to the owner of the property.
Texas Department of Insurance | www.tdi.texas.gov
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Certification
I,
, an authorized representative of
roofing company, do hereby certify that
I installed the roof covering on the property listed above according to manufacturer specifications. The roof covering is listed as complying with Underwriters’ Laboratory Standard 2218, Impact Standard for Impact Resistance of Prepared Roof Covering Materials, and has an impact resistance Classification of:
Class 1
Class 2
Class 3
Class 4
Roofing Company Representative Signature
Date
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Order Birth Certificate Texas - It serves as an acknowledgment by the State of Texas of the importance of having one’s personal documents in correct order.
Public Information Report - The rendition form is part of Texas's efforts to ensure a fair valuation and taxation process for mobile homes within its jurisdictions.