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Content Overview

The Texas PC068 form serves as an important tool for homeowners seeking to reduce their residential insurance premiums through proper roofing installation. This certification form is issued by the Texas Department of Insurance and is specifically designed for residential property owners who have installed roofs that meet certain impact resistance standards. By completing this form, homeowners can demonstrate that their roofing materials comply with Underwriters’ Laboratory Standard 2218, which is crucial for obtaining a premium discount. 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 brand name and classification of impact resistance. Homeowners must also provide their own contact information and the address of the residence where the roofing work was performed. An authorized representative from the roofing company must sign the form, certifying that the installation adhered to the manufacturer’s specifications. It is essential to understand that while this certification can lead to a reduction in insurance costs, it does not imply any warranty from the roofing manufacturer or installer. Additionally, any misrepresentation on this form can lead to serious consequences, including charges of fraud.

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PC068 | 0423
Texas Department of Insurance | www.tdi.texas.gov 1 of 2
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
Name
Address
City State ZIP
Phone
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 2 of 2
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

Form Specifications

Fact Name Details
Purpose The Texas PC068 form is used to certify roofing installation for residential properties to qualify for insurance premium reductions.
Governing Law This form is governed by Texas Insurance Code, specifically relating to residential property insurance.
Impact Resistance The roofing materials must comply with Underwriters’ Laboratory Standard 2218, which assesses impact resistance.
Classifications Roof coverings are classified into four classes based on their impact resistance: Class 1, Class 2, Class 3, and Class 4.
Signature Requirement The form must be signed by an authorized representative of the roofing company to be valid.
Documentation Homeowners must receive a copy of the form, while the second copy is submitted to the insurance company.
Fraud Warning Any intentional misrepresentation on the form may constitute fraud, which has legal consequences.
Retention of Copies One copy of the form should be retained by the homeowner for their records.

Texas Pc068: Usage Guidelines

Filling out the Texas PC068 form is a straightforward process that can help homeowners receive a reduction in their residential insurance premiums. Below are the steps to ensure that the form is completed accurately.

  1. Obtain the Form: Download the Texas PC068 form from the Texas Department of Insurance website or request a physical copy.
  2. Fill in Roofing Company Information: Write the name, street address, city, county, zip code, phone number, and license number (if applicable) of the roofing company.
  3. Provide Homeowner Information: Enter the name of the homeowner, home phone number, office phone number, address, city, county, and zip code of the residence where the roof was installed.
  4. Certification Section: The authorized representative of the roofing company should fill in their name and certify that the roof covering has been installed according to the manufacturer's specifications.
  5. Impact Resistance Classification: Indicate the impact resistance classification of the roof covering (Class 1, Class 2, Class 3, or Class 4) and provide the manufacturer's name, brand name, year manufactured, and date of installation.
  6. Labeling Information: Check the appropriate box regarding the labeling of the roof covering products, ensuring that the required information is provided.
  7. Signature: The authorized representative must sign and date the form to validate the certification.
  8. Distribute Copies: Retain one copy for the homeowner and send the second copy to the insurance company.

Once the form is completed and signed, it is important to keep a copy for personal records and submit the other copy to your insurance provider. This will help facilitate the reduction in your insurance premium.

Your Questions, Answered

What is the Texas PC068 form?

The Texas PC068 form is a certification document that homeowners can use to obtain a reduction in their residential insurance premiums. It is specifically designed for roofing installations that comply with certain standards for impact resistance. The form must be completed by the roofing company that installed the roof.

Who needs to fill out the Texas PC068 form?

The form must be filled out by an authorized representative of the roofing company that performed the installation. Homeowners should ensure that their roofing contractor completes the form accurately, as it is essential for securing the insurance premium reduction.

What information is required on the Texas PC068 form?

The form requires several pieces of information, including the name and contact details of the roofing company, the homeowner’s details, and specifics about the roofing materials used. This includes the manufacturer’s name, brand name, and the classification of the roofing material according to Underwriters’ Laboratory Standard 2218.

What is the purpose of the certification on the form?

The certification on the Texas PC068 form serves to confirm that the roofing installation meets the necessary standards for impact resistance. By providing this certification, homeowners can qualify for a reduction in their residential insurance premiums, which can lead to significant savings.

What are the impact resistance classifications mentioned in the form?

The form references four classifications of impact resistance: Class 1, Class 2, Class 3, and Class 4. Class 4 indicates the highest level of impact resistance, which may qualify homeowners for the greatest premium reductions. Homeowners should consult with their roofing contractor to understand which classification their new roof meets.

Is there a deadline for using the Texas PC068 form?

While there is no specific deadline for submitting the form, homeowners should complete it promptly after the roofing installation to ensure they can take advantage of the premium reduction. It is advisable to check with their insurance provider regarding any time limits for submitting documentation related to premium discounts.

What happens if the form is filled out incorrectly?

If the Texas PC068 form is filled out incorrectly, it may result in delays or denial of the premium reduction. Homeowners should carefully review the completed form for accuracy and ensure that all required information is provided before submission to their insurance company.

Can the Texas PC068 form be used for commercial properties?

The Texas PC068 form is specifically designed for residential properties. Homeowners seeking premium reductions for commercial properties will need to consult their insurance provider for alternative forms or requirements that may apply to commercial roofing installations.

What should homeowners do with the completed form?

After the Texas PC068 form is completed and signed by the roofing company's authorized representative, homeowners should retain one copy for their records and submit the second copy to their insurance company. Keeping a copy is important for future reference and verification of the insurance premium reduction.

Common mistakes

  1. Incomplete Information: Many individuals fail to provide all required details, such as the roofing company's name, address, or license number. Missing information can lead to delays or denial of the premium reduction.

  2. Incorrect Classification: Selecting the wrong impact resistance classification can be a costly mistake. Ensure that the roof covering meets the correct standards under U.L. Standard 2218.

  3. Signature Issues: The form must be signed by an authorized representative of the roofing company. Omitting this signature or having an unauthorized person sign can invalidate the certification.

  4. Failure to Attach Labels: Homeowners often forget to include the necessary labels from the roofing product packaging. These labels are crucial for verifying compliance with the U.L. classification.

  5. Incorrect Dates: Providing an incorrect installation date can raise red flags. Double-check that the date reflects when the roofing was actually installed.

  6. Not Retaining Copies: After filling out the form, homeowners sometimes neglect to keep a copy for their records. Retaining a copy is essential for future reference and to ensure that all parties have the necessary documentation.

Documents used along the form

The Texas PC068 form is essential for homeowners seeking a reduction in their residential insurance premiums after a new roof installation. However, several other forms and documents are commonly used alongside it to ensure a smooth process. Here’s a brief overview of these important documents.

  • Texas Department of Insurance Form TDI-20: This form is used to report any changes in your insurance policy or coverage. It helps keep your insurance provider informed about your current situation, ensuring that your policy remains valid and up-to-date.
  • Proof of Insurance: This document serves as evidence that you have an active insurance policy covering your property. It is often required when applying for discounts or during the mortgage process.
  • Roofing Contract: This contract outlines the terms and conditions agreed upon between the homeowner and the roofing company. It details the scope of work, costs, and timelines, ensuring both parties are on the same page.
  • Manufacturer’s Warranty: This document provides information about the warranty offered by the roofing material manufacturer. It typically covers defects and guarantees the quality of the materials used.
  • Inspection Report: An inspection report from a licensed inspector may be required to verify that the roofing installation meets local building codes and standards. This ensures the work is done correctly and safely.
  • Homeowner’s Association Approval: If your property is within a homeowner’s association (HOA), you may need to submit a request for approval before making any exterior changes, including roofing. This document shows that you have complied with HOA regulations.
  • Insurance Claim Form: In the event of damage to your roof, this form is used to file a claim with your insurance company. It initiates the process for potential reimbursement for repairs or replacements.
  • Disclosure Statement: This document outlines any known issues or defects with the property that could affect the roof's condition. It is crucial for transparency during the sale or insurance process.
  • Permit Application: Depending on local regulations, a permit may be required before commencing roofing work. This application ensures that the project complies with local building codes.

Understanding these documents is crucial for homeowners looking to maximize their benefits from the Texas PC068 form. Each plays a role in ensuring compliance, protecting your investment, and securing the best possible insurance rates.

Similar forms

The Texas PC068 form is designed to help homeowners obtain a reduction in their residential insurance premiums by certifying that their roofing has been installed according to specific standards. This form is similar to several other documents in its purpose and function. Below are seven documents that share similarities with the Texas PC068 form:

  • Certificate of Insurance: This document provides proof that an insurance policy is in effect. Like the PC068, it serves to verify compliance with certain requirements, helping homeowners secure benefits or reductions.
  • Homeowner’s Insurance Application: This application collects information about the property and its condition. Similar to the PC068, it is crucial for determining eligibility for insurance premium reductions.
  • Roofing Warranty Certificate: This certificate confirms that the roofing work meets specific standards and comes with a warranty. It parallels the PC068 in that both documents assure quality and compliance with industry standards.
  • Building Permit: A building permit is required for construction and renovation projects. Like the PC068, it ensures that the work complies with local codes and standards, which can affect insurance premiums.
  • Inspection Report: An inspection report evaluates the condition of a property, similar to how the PC068 assesses roofing compliance. Both documents play a role in influencing insurance rates based on property conditions.
  • Proof of Loss Form: This form is used to claim insurance benefits after a loss. Like the PC068, it documents specific details necessary for processing claims and can impact the amount of compensation received.
  • Contractor’s Affidavit: This affidavit confirms that a contractor has fulfilled their obligations under a contract. It is similar to the PC068 in that it provides verification of work done, which can affect insurance premiums.

Dos and Don'ts

When filling out the Texas PC068 form, it’s important to be careful and thorough. Here are five things to keep in mind:

  • Do read the entire form carefully before starting. Understanding what is required will help ensure accuracy.
  • Do provide complete and accurate information. Missing details can delay the process or affect your insurance premium.
  • Do double-check the manufacturer’s specifications for the roofing materials used. This ensures compliance with the necessary standards.
  • Don't leave any sections blank. Each part of the form needs to be filled out to avoid confusion.
  • Don't provide false information. Misrepresentation can lead to serious consequences, including fraud charges.

By following these guidelines, you can help make the process smoother and more efficient.

Misconceptions

Understanding the Texas PC068 form can be crucial for homeowners looking to save on their residential insurance premiums. However, several misconceptions often arise about this form. Here’s a breakdown of nine common misunderstandings:

  • This form guarantees a reduction in insurance premiums. Many homeowners believe that simply filling out the PC068 form will automatically lower their premiums. In reality, while it may help, the final decision lies with the insurance company.
  • Only certain roofing companies can complete the form. Some think that only specific licensed contractors can fill out the PC068. In truth, any authorized representative from a roofing company can complete it, as long as they meet the necessary criteria.
  • The form serves as a warranty for roofing materials. A common misconception is that the PC068 form acts as a warranty. It does not provide any warranty or guarantee from the manufacturer, supplier, or installer regarding the roofing materials.
  • All roofs qualify for a premium reduction. Homeowners may assume that any roofing installation qualifies for a premium reduction. However, only roofs that meet specific impact resistance classifications are eligible.
  • The form must be submitted before installation. Some believe that the PC068 must be submitted prior to roofing work. In fact, it can be completed after installation as long as the roofing meets the required standards.
  • Labels on roofing materials are optional. A frequent misunderstanding is that labeling is not necessary. However, since January 1, 1999, all individual roofing materials must be labeled according to U.L. Standard 2218.
  • Homeowners must keep the original form. There’s a belief that homeowners need to retain the original form for their records. While it’s important to keep a copy, the original should be submitted to the insurance company.
  • Filing the form is a straightforward process. Many homeowners think the process is simple and quick. However, it requires careful attention to detail to ensure all necessary information is accurately provided.
  • Misrepresenting information on the form is harmless. Some may think that minor inaccuracies are inconsequential. This is not true, as any intentional misrepresentation can be considered fraud, leading to serious consequences.

By clarifying these misconceptions, homeowners can navigate the Texas PC068 form more effectively and potentially benefit from the insurance premium reductions it offers.

Key takeaways

Filling out the Texas PC068 form can help homeowners reduce their residential insurance premiums. Here are some key takeaways to keep in mind:

  • Purpose of the Form: The Texas PC068 form is designed to certify that a roofing installation meets specific standards, enabling homeowners to qualify for a reduction in their insurance premiums.
  • Roofing Company Information: Homeowners must provide detailed information about the roofing company, including its name, address, phone number, and license number if applicable.
  • Installer’s Certification: An authorized representative from the roofing company must certify that the installation complies with the manufacturer's specifications and Underwriters’ Laboratory Standard 2218.
  • Impact Resistance Classification: The form requires the classification of the roof covering's impact resistance, which can be Class 1, Class 2, Class 3, or Class 4.
  • Labeling Requirements: The roof covering must be properly labeled with the manufacturer’s name, date of manufacture, and brand name. This labeling is crucial for compliance.
  • Submission Process: After completion, one copy of the form should be retained by the homeowner, and another copy must be sent to the insurance company.
  • Fraud Warning: Any intentional misrepresentation on the form is considered fraud, which can have serious legal consequences.