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Name
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Phone
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Email
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How many windows need repair?
1
2
3
more
What type of window glass? (Check all that apply)
Single Pane
Dual Pane
Dual Pane with Grids
Clear Glass
Low E Glass
Tinted Glass
Sliding
Stationary
Other
What is the approximate measurement of the window?
Where is the window located?
Upstairs
Downstairs
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What are your major cross streets?
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