Quotations

What room needs heating *

Length (cm) *

Width (cm) *

Heigth (cm) *

Free floor surface

Heatingsystem Floor (< 2.5 cm) Floor (2.5 cm - 5 cm) Floor (> 5 cm) Wall Ceiling

Floor covering Tiles Wood Carpet Vinyl Not Applicable

Main or auxiliary heating? Main Auxiliary

Is there another heating source in the room? Yes No

Type of heating source?

Date of construction (house)

Insulation of the room Good Reasonable Bad

Insulation of the floor Good Reasonable Bad

Company name

Title Mr. Mrs. Ms. Miss. Dr. Rev.

Name

Address *

Postal code *

City *

Telephone number

Fax number

I would like to receive this quotation via: Email Post Fax

Email *

Remarks

Anti-spam code