| CUSTOMER INFORMATION |
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| * Company |
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| * Name and surname |
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| * Street and number |
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| * Postal code |
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| * City |
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| Country |
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| * E-mail |
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| * Home phone |
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| * Work phone |
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| Skype account |
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| www |
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| TECHNICAL INFORMATION |
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| Object type: |
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| * Required heating power (kW): |
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| Heated space volume (m3) |
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| Required fuel: |
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| * Required medium: |
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| Request for WSW (m3/h) |
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| WSW purpose - number of apartments |
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| WSW purpose -max. number of showers |
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| WSW purpose - max. number of showering persons in peak hours |
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| Self-support smoke stack (max 8 m) - we request the height (m) |
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| Smoke stack on object facade - we request the height (m) |
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| Height of the nearest object (m) |
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| Distance from the nearest object (m) |
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| SUPPLEMENTARY INFOMATION |
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| Input gas pressure (kPa) |
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| Volume of supply water (litres or m3) |
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| Present operational pressure of supply water (steam) (kPa) |
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| Planned investment for rental - monthly (depends on the source size, rental period and number of candidates) besides media consumption |
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| REQUESTS FOR RENTAL |
fill in only in case of interest in rental |
| Boiler rooms location - address |
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| Supposed rental period (in months) |
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| Supposed rental date, from |
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Supposed rental date, to |
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| We are interested in rental included operating |
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| We are interested in rental with heat supply and sale |
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| We are interested in longterm rental followed by purchase |
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The common emergency service in 24 hours is included in the price.
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| REQUEST FOR PURCHASE |
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| We are interested in purchase of already manufactered and rented boiler room |
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| We are interested in production and purchase of a new boiler room |
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| REQUESTS - STEAM BOILER ROOMS |
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| Local water hardness (mmol/l chem.equivalents) |
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| Condensate return (%) |
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| Temperature of returned condensate (°C) |
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| OTHER REQUESTS |
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