LaValley Building Supply Service Request Form

TRUSTED by homeowners of the Upper Valley since 1980

DPW Construction, LLC

PO Box 105
Hartland Four Corners, VT 05049
802.436.2861
603.252.7461

Copyright © DPW Construction 2013

LaValley  Building Supply employees should complete this form when requesting service from DPW Construction.

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CUSTOMER INFORMATION

FIRST NAME

LAST NAME

EMAIL

PHONE

HOUSE # & STREET

CITY/TOWN

STATE

CONTACT NOTES

PRODUCT INFORMATION

MANUFACTURER

PRODUCT ID/CIG

LABOR WARRANTY?

PART WARRANTY?

REQUEST/DEFECT

LAVALLEY BUILDING SUPPLY INFORMATION

PURCHASE ORDER #

NOTES

YOUR NAME

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Call for a consultation:  802.436.2861