Contractor's E-mail Address: *

DETAILS OF CUSTOMER (PROPERTY WHERE INSTALLED)

Client Name

Client Contact Number

Client Mobile Number

Client Address

Client Postcode

Client Email

DETAILS OF INSTALLER

Installer Name

Installer Contact Number

Installer Mobile Number

Installer Address

Installer Postcode

Installer Email

DETAILS OF HEATING MAT INSTALLATION

Room where fitted

Concrete or Timber Subfloor
Timber Concrete

Size of Mat

Stock No.

Serial No.

RCD Fitted
yes no

Installation Date

Part P Certificate No.

PURCHASE DETAILS

Date of Purchase

Where Purchased

DOCUMENTATION DETAILS
PLEASE CONFIRM THAT YOU HAVE THE FOLLOWING
DOCUMENTS AVAILABLE, THESE WOULD HAVE BEEN LEFT
WITH THE HOUSEOWNER ON COMPLETION

Warranty Form
yes
No

Factory Test Certificate
yes
no

Purchase Receipt
yes
no

ADDITIONAL COMMENTS
PLEASE USE THIS SPACE FOR ANY OTHER DETAILS OR
OBSERVATIONS ABOUT THE PROBLEM YOU ARE EXPERIENCING

DECLARATION
I CONFIRM THAT THESE DETAILS ARE TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE

Name

Date





Create Email Forms