West Virginia Insured Residential Roofing Contract

West Virginia Insured Residential Roofing Contract

Before signing: Complete and give the owner the contractor's contact details, the statutory warning, and two completed, detachable cancellation notices. Print the warning and both notices in bold type of at least 10 points. Check whether another state or federal cancellation rule also applies.

1. Parties and project

Contract date: [__/__/____]

Owner / customer: [FULL LEGAL NAME]

Residential property: [STREET ADDRESS, CITY, WEST VIRGINIA ZIP]

Owner's mailing address, if different: [ADDRESS]

Roofing contractor legal name: [FULL LEGAL NAME]

Contractor's physical and mailing address for notices: [ADDRESS]

Contractor's telephone: [NUMBER] Email, if applicable: [ADDRESS] Fax, if applicable: [NUMBER]

Contractor's license or registration details, if applicable: [DETAILS]

The owner expects all or part of the roof work to be paid from the proceeds of a property and casualty insurance policy. The owner controls the claim and insurer communications. The contractor may supply a roof estimate and confer with the insurer's representative after the owner has submitted a claim, but will not represent or negotiate the claim for the owner.

2. Work and schedule

Roof components and existing damage: [DESCRIBE COVERING, FRAMING, INSULATION, SHEATHING, VENTILATION, GUTTERS, WEATHERPROOFING, OR OTHER WORK]

Work and materials, including manufacturer, model, color, and quantities: [DETAILED SCOPE OR SIGNED EXHIBIT]

Excluded work: [DETAILS OR NONE]

Permits and inspections; party responsible: [DETAILS]

Estimated start date: [__/__/____] Estimated completion date: [__/__/____]

Site access, protection, debris removal, and cleanup: [DETAILS]

Workmanship and manufacturer warranties, if any: [TERMS OR NONE]

A change in work, price, or schedule requires a written change order signed by both parties before the changed work begins.

3. Price, insurance, and payment

Contract price: $[AMOUNT] Itemized price exhibit: [IDENTIFY OR NONE]

Insurer and claim number, if known: [DETAILS OR UNKNOWN]

Deductible and other owner-paid amounts: [AMOUNT AND DESCRIPTION OR UNKNOWN]

Payment milestones after the statutory cancellation period expires: [DATES, AMOUNTS, AND CONDITIONS]

The contractor will not require an advance payment until the cancellation period in W. Va. Code § 46A-6M-2 has expired, except a reasonable and customary charge for an emergency repair the owner authorized. If the owner cancels under that section, the contractor will tender payments, deposits, and evidence of indebtedness within ten days, subject to that emergency-repair exception. No cancellation fee for other work applies.

The contractor will not offer to pay or rebate an insurance deductible or claim proceeds as a sales inducement, or pay the owner a bonus, coupon, credit, gift, prize, referral fee, or other thing of monetary value for the covered work.

4. Emergency repair authorization, if needed

Immediate risk of injury or further property damage: [DESCRIBE OR NONE]

Specific emergency repair authorized: [DESCRIBE OR NONE]

Reasonable and customary charge: $[AMOUNT OR TO BE DOCUMENTED]

Owner's separate authorization: ____________________ Date: [__/__/____]

5. Statutory cancellation warning

The following warning must be furnished before the parties enter this contract. The reproduced warning and attached notices come from W. Va. Code § 46A-6M-3. The statute's notice form contains a “fifth day” phrase; § 46A-6M-2(a) states the operative period as the fifth business day after the owner's receipt of the insurer's denial notice.

Because you expect all or part of the cost of the roofing repair or replacement to be paid out of the proceeds of a property and casualty insurance policy, you may cancel this contract at any time before midnight on the fifth business day after you have received written notification from your insurer that all or any part of the claim or contract is not a covered loss under the insurance policy. This right to cancel is in addition to any other rights of cancellation you may have under state or federal law or rule or regulation. However, be advised that if you cancel this contract, you are still responsible to pay the reasonable and customary expenses of any emergency repair services you authorized. See the attached Notice of Cancellation form for an explanation of this right.

Owner acknowledges receipt of this warning and two completed, detachable notices before signing: [INITIALS] Date: [__/__/____]

6. Cancellation delivery and signatures

If the insurer notifies the owner that all or part of the claim is not covered, the owner may cancel before midnight of the fifth business day after receiving that notice. The owner may personally deliver written notice, mail it postage prepaid to the contractor's address above, fax it, or email it. Any written expression of intent not to be bound is sufficient. The statutory notice below is available for convenience.

Owner signature: ______________________________ Date: [__/__/____]

Contractor authorized signature: ______________________________ Date: [__/__/____]

Contractor printed name and title: [NAME AND TITLE]

Completed contract and two cancellation notices delivered to owner: [DATE AND METHOD]

Detachable notice of cancellation — copy 1

NOTICE OF CANCELLATION

[CONTRACT DATE]

If you are notified by your insurer that all or any part of the claim or contract is not a covered loss under the insurance policy, you may cancel this contract without penalty or monetary obligation, except where you have authorized emergency repair services for which you are still responsible for payment, before midnight of the fifth business day after you have received notice from your insurer. To cancel this transaction you may use any of the following methods: Mail or otherwise deliver a signed and dated copy of this cancellation notice, or any other written notice of cancellation which you- sign-and date, to [CONTRACTOR PHYSICAL ADDRESS], or e-mail a notice of cancellation to [CONTRACTOR EMAIL ADDRESS], or transmit a notice of cancellation to [CONTRACTOR FAX NUMBER], not later than midnight of the fifth day after you receive notice from your insurer. By signing below, you certify that your insurer has denied all or part of your claim.

I HEREBY ATTEST THAT I HAVE BEEN NOTIFIED BY THE INSURER THAT ALL OR PART OF MY CLAIM HAS BEEN DENIED AND I HEREBY CANCEL THIS TRANSACTION.

[DATE]

[BUYER SIGNATURE]

Detachable notice of cancellation — copy 2

NOTICE OF CANCELLATION

[CONTRACT DATE]

If you are notified by your insurer that all or any part of the claim or contract is not a covered loss under the insurance policy, you may cancel this contract without penalty or monetary obligation, except where you have authorized emergency repair services for which you are still responsible for payment, before midnight of the fifth business day after you have received notice from your insurer. To cancel this transaction you may use any of the following methods: Mail or otherwise deliver a signed and dated copy of this cancellation notice, or any other written notice of cancellation which you- sign-and date, to [CONTRACTOR PHYSICAL ADDRESS], or e-mail a notice of cancellation to [CONTRACTOR EMAIL ADDRESS], or transmit a notice of cancellation to [CONTRACTOR FAX NUMBER], not later than midnight of the fifth day after you receive notice from your insurer. By signing below, you certify that your insurer has denied all or part of your claim.

I HEREBY ATTEST THAT I HAVE BEEN NOTIFIED BY THE INSURER THAT ALL OR PART OF MY CLAIM HAS BEEN DENIED AND I HEREBY CANCEL THIS TRANSACTION.

[DATE]

[BUYER SIGNATURE]

Sources and references

• W. Va. Code §§ 46A-6M-1 through -5 — current official chapter PDF, generated November 5, 2026, governing insured residential roof contracts, cancellation notices, payment, and prohibited acts.