BOILER SERVICING APPLICATION








Does your boiler heat water and central heating?

YesNoUnsure

Age of boiler (Years)

Service Agreement
annual service (parts charged seperately)
YesNo
Maintenance Contract
(parts covered as per Maintenance Contract)
YesNo

I have read and I understand the Terms and Conditions overlead and confirm to the best of my knowledge, that my boiler is in good working order.