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First and last name: 
 
    
 
 
Company: 
 
    
 
 
Phone: 
 
 
 
 
Fax: 
 
    
 
 
Mobile: 
 
    
 
 
Email:
 
   
 
 
We are: 
 
    
Private
Plumber
Planner 
Constructor

 
 
Request:
 
   
 
 
Date of construction: 
 
        
 
 
Building: 

    
Existing building
New building

 
Heated area:
 
       m2
 
 

 
Construction plans available:
 
    
Yes  
No       

 
 
Heat demand available:
 
    
Yes  
No     
 
 
Desired heat source:
 
    
Air-Water
Ground-Water  
Water-Water
 
 
Heatings:
 
    
Radiator
Floor heating
Wall heating
Convector
 
 
Typ of building:
 
    
Private house
Multiple-unit residence
Commercial property
 
 
 
Would you like us to call you? 
 
    
Yes
No
    
 
 
Would you like an on-site visit?      
Yes
No
    
 
 
Would you like a quotation? 
 
    
Yes  
No
    
 
 
   
 





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