New 100 lbs Commercial Gas Installation

Please note: this application form is for commercial 100 lbs cylinders only. If you are interested in a bulk installation, please contact our Customer Service at +599 9 869 7333 for additional information.

    Company Information




    Contact Person - Applicant








    YesNo

    Position of gas cylinders


    YesNo


    YesNo


    YesNo


    YesNo

     


    YesNo


    YesNo


    YesNo

    Connections


    YesNo


    YesNo


    YesNo

     


    YesNo


    YesNo

    Conditions

    • The applicant gives CURGAS N.V. explicitly permission to drill into the house wall (if necessary) for the
      gas installation, whereby the applicant indicates about the position of water pipes and wiring for electricity
      and telephone in the wall. CURGAS N.V. accepts no liability for any damage or costs arising from installation
      work that are due to incorrect or incomplete information provided by the applicant.
    • The prices of materials and cylinders are subject to price changes. The prices payable by the applicant are
      the current prices on the date of installation. Any differences between the already paid amounts and the
      amounts due are for the account of the applicant.
    • CURGAS N.V. only uses materials supplied by Curgas N.V.
    • If CURGAS N.V. is unable to make the installation on the agreed date because no adult person was present or
      because the information provided by the applicant was incorrect or incomplete, ANG 40.00 in travel costs will be charged.