Reseller details
Reseller name
*
First name
Last name
Reseller company
*
Enter the name of your company.
Reseller email
*
Enter your business email address.
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Customer details
Customer name
*
First name
Last name
Customer company
*
Enter the name of the customer’s company.
Customer email
*
Enter the customer’s business email address.
Customer phone number
*
-
Area Code
Phone Number
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Site information
Type of building
Please Select
Office
Factory
Industrial unit
Hospital
Healthcare facility
School
University
Warehouse
Distribution centre
Retail
Shopping centre
Hospitality
Hotel
Restaurant
Leisure facility
Workshop
Garage
Public sector building
Government building
Other
Select the option that best describes the site where the appliances are located.
Site address
*
Street
Country
City
Province
Postal Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Boilers
Any boilers on site?
*
Please Select
Yes
No
Select Yes if the site has any boilers installed.
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Boiler information
Boiler type
Please Select
Heating only
Heating & Hot water
Choose the option that best describes this boiler’s function.
Boiler fuel type
Please Select
Gas
Oil
LPG
Select the fuel used by this boiler.
Quantity of boilers
Enter the total number of boilers of this type on site.
Boiler output (kW)
Enter the boiler output in kilowatts (kW) as shown on the data plate. Leave blank if unknown.
Boiler efficiency (%)
Enter the efficiency percentage from the data plate if available. Leave blank if unknown.
Boiler photos
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Please upload a clear photo of each boiler and its data plate. If there are multiple boilers, upload separate photos for each one.
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Warm air heaters
Any warm air heaters on site?
*
Please Select
Yes
No
Select Yes if the site has any warm air heaters installed.
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Warm air heater information
Warm air heater fuel type
Please Select
Gas
Oil
LPG
Select the fuel used by this warm air heater.
Warm air heater output (kW)
Enter the output in kilowatts (kW) as shown on the data plate.
Warm air heater efficiency (%)
Enter the efficiency percentage from the data plate if available. Leave blank if unknown.
Quantity of warm air heaters
Enter the total number of warm air heaters of this type on site.
Warm air heater photos
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Choose a file
Please upload a clear photo of each warm air heater and its data plate. If there are multiple units, upload separate photos for each one.
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Water heaters
Any water heaters on site?
*
Please Select
Yes
No
Select Yes if the site has any water heaters installed.
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Water heater information
Water heater fuel type
Please Select
Gas
Oil
LPG
Select the fuel used by this water heater.
Water heater output (kW)
Enter the output in kilowatts (kW) as shown on the data plate.
Water heater efficiency (%)
Enter the efficiency percentage from the data plate if available. Leave blank if unknown.
Quantity of water heaters
Enter the total number of water heaters of this type on site.
Water heater photos
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Drag and drop files here
Choose a file
Please upload a clear photo of each water heater and its data plate. If there are multiple units, upload separate photos for each one.
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Additional site information
Is there catering on-site using gas/LPG?
Please Select
Yes
No
Select Yes if the site has any catering facilities that use gas or LPG appliances.
Additional notes
Add any extra information about the site or appliances that may help us prepare an accurate proposal.
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