Vancouver Island Floor Covering Association

Request to Consumer Affairs Committee: Request for Inspection Form

ALL fields are required. If you do not know an answer, please type "unknown".
Once you submit the completed form, you will receive a copy as well.

Inspection Requested By:

Member's Name:
Store Address:
Store City:
Store Postal Code:
Store Phone Number:
Store Email:
Sales Person:
Date of Installation:

Consumer's Name:
Address:
City:
Province:
Postal Code:
Email Address:
Telephone:

Nature of Problem:
Construction Method (e.g. on grade slab, crawl space, etc.):
Date of Consumer's Complaint:
Product Name in Full:
Manufacturer:
Distributor:
Has the Store Manager viewed the problem?
Has the Product Representative viewed the problem? If yes, please send a copy of their report with your cheque to the address below.
Steps already taken to resolve this problem:
CHARGES:
for members $350 + GST
for non-members $450 + GST
Ferries and long-distance travel are extra.
Complaint will be viewed when payment is received. Send a cheque to: VIFCA, 1075 Alston Street, Victoria, BC V9A 3S6