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First Name

Last Name

Email

Phone/Mobile

Duration of hire?
(minimum hire 4 weeks)

Start Date

End Date

Existing Boiler Type

Electric

Gas

Oil

Existing Boiler Size (KW)

KW

Supplies

Heating

Hot Water

Both

Hot water requirement

Refeeding existing HWS primary supply

Requires DHW PHEX supplied

All fuel and costs are subject to economic fluctuations and would be supplied at current prices. All fuel supplied on a sale only basis. This will be quoted separately from any quotation in relation to the temporary boiler hire.

Site Address

Address Line 1

Address Line 2

Town/City

County

Post Code

Please use what3words to pinpoint the boilers location and leave the results in the box below.

What 3 Words

Is your mains water connection within 20m?

Yes

No

Mains water connection size?

1/2" (15mm)

3/4" (22mm)

1" (28mm)

*Other

*Please specify

Fencing required?

Yes

No

How many square meters do you require?

sq/m

Any kerbs or steps required to be navigated?

Yes

No

Location of existing boiler(s)

Basement

Ground Floor

If above ground level, please select height of existing boiler(s) in Meters

m

Is ground flat and level (indicate incline in º)

0

Are there any access and/or road restrictions?

Yes

No

Please provide details

Working hours restrictions?

8-5 Monday to Friday

Weekends Only

Out of Hours Only

No Restrictions

Site induction required?

Yes

No

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