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Name: Day Phone:
Email: Address: City: , CA Zip Code: How did you hear about us? Internet Yellow Pages Radio/TV Other __________________ What type of work do you need?
Repair Replacement
What type of door needs to be repaired / replace? Is it electrically operated? What problems do you need repaired? Damaged Sections Broken Springs Broken door parts Worn out hardware Rollers out of track Bent or damaged tracks Cable off the drums Door won’t close Other Door won’t open Door damaged, broken, dented, etc. Broken door parts Gaps around door (bottom, side or top) when closed What is the approximate size? Single car garage door Double car garage door Other Do you want a garage door opener installed with your new garage door? No Yes, new system installed Yes, existing system re-installed Other Don’t Know What type of Garage Doors are you interested in? Steel Vinyl Sectional Plain glass panels Other Aluminum Fiberglass Custom (wood application) Tilt- Up Decorative glass panels Masonite Appointment: _______________________________________________________ Comments: _________________________________________________________