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HOMEPAGE
WORK WITH US
OFFER REQUEST
CONTACTS
EN
FR
IT
NL
HOMEPAGE
WORK WITH US
OFFER REQUEST
CONTACTS
EN
FR
IT
NL
Offer
REQUEST
Preventivo EN
Name
*
Surname
*
City
*
Adress
*
Postcode
*
Phone number
Mobile number
Mail
*
Number of family members
Housing type
Individual house
Apartment
Building project
Building site
Type of construction
4 facades
3 facades
2 facades
Construction year
Energetic efficiency
A
B
C
D
E
F
Use
Private
Professional
Mixed
Second home
Yes
No
Private gross surface
Professional gross surface
Surface (lenght)
Surface (width)
Photovoltaic system
*
Yes
No
Roof terrace
*
Yes
No
Roof surface
Slanted roof
*
Yes
No
Orientation of sloping roofs
*
North
To the east
South
West
Meter type
*
Mono meter
Hour meter
Annual electricity consumption - day (peak hours)
Annual electricity consumption - night (off-peak hours)
Annual electricity consumption only night
Total power of installed batteries (kW)
Sales representative’s name (if you have been in contact with one of our Sales representatives)
Number of batteries
Battery voltage
Battery type
Type of heating system
Electric
Gas
Heat pump
Others
Your annual consumption
Number of heaters
Means of hot water production
Electric boiler
Gas furnace
Gas furnace (connected to furnace)
Fuel feed for the boiler (connected to boiler)
Number of hybrid cars in the household
Number of electric motorbikes/bicycles in the household
Number of electric bicycles in the household
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