Request your project warranty

Complete this form on your phone or computer, then download your completed warranty request in the original KOSTER PDF format.

Fields marked * are required. Keep answers concise so they fit on the original one-page form.

01 / APPLICATOR

Approved applicator

KOSTER approved applicator *Street addressCityStateZIP codeContact namePhoneFaxEmail *KOSTER representative or distributor

02 / PROJECT

Project information

Project name *Project street addressProject cityProject stateProject ZIP code

03 / DOCUMENTATION

Products and application

Date project startedDate project finishedVAP product appliedPrimer appliedSelf-leveling underlayment appliedFloor area coated (sq ft)OwnerFlooring system installed over the KOSTER VAP I productBatch numbers of VAP, primer, and underlayment

Please attach a floor plan of the building and mark the areas that were coated. If batch numbers do not fit, attach a separate batch list and enter “See attached batch list” above.

04 / MAILING

Mail original warranty to

NameStreet addressCityStateZIP codeContact namePhoneEmail

05 / ACKNOWLEDGMENT

Approved applicator acknowledgment

I hereby certify that I have applied all products in strict compliance with all KOSTER application specifications on “structurally sound” and clean areas in which the concrete meets acceptable industry standards, after appropriate testing to confirm the substrate is suitable for the application of the product. Any information that is erroneous or incomplete will result in the cancellation of any warranty provided or promised for this project or voiding of any warranties to be supplied by KOSTER American Corp for any of its products involved in this project.

I acknowledge that the provided information is accurate and true to the best of my knowledge. *

Your typed name records your acknowledgment. It is not a digital certificate signature. KOSTER may request a separately signed copy.

Applicator signature — type your name *Date *Printed name and title *

Download and email your request

Download your completed PDF, then attach it and the marked floor plan to your email. Include any separate batch list. Attachments must be added in your email app.

The form keeps your entries on this page while it is open. Download before closing or refreshing. Nothing is submitted automatically.