Email: Only your email address and/or ref. no is necessary if you have registered before. WPG Ref. No.: Name: Company: Address: City: Postcode: Tel: Fax: Your purchase order number: Please describe your application:

	Nearest town: Site Company Site Contact Name: Site Address: If different from address above. Site City: Site Postcode: Site Tel: Site Fax: Directions to site: Offloading Access: Access Height Restrictions: Space Available on Site: Length: Width: Height:

	We need the following details to prepare a quotation - this does not represent a binding offer. Power required:  kVA  Volts  Phase  50 60  Hz Utilisation: Please pick one  Standby  50 hrs/week  168 hrs/week  hrs/week Equipment on Site: Cabins: Fuel supply:  WPG fuel management service  Self supply WPG bunded fuel tank: Please pick one  1350 Litres  2600 Litres  Other Do you require distribution boards?  240V  415V  Other Do you require a wiring installation? Please choose one  Yes  No Cable size: Please pick one  6mm  10mm  16mm  35mm  120mm  Other Cable length: Please pick one  25mtr  50mtr  100mtr Other:

	Please quote me for:  Hire  Hire with Option to Purchase  Purchase Any other information: Our sister company Fidelity supplies a wide range of contractor's general plant. Please tick what you require and we will contact you.  Compaction Equipment  Dumpers  Compressors  Mini-Excavators  Transport