Boiler Maintenance Contract
DOMESTIC BOILER MAINTENANCE / SERVICE APPLICATION
Name :
Address :
Town / city
Region :
Postcode :
Telephone :
Email Address :
Gleaner A/C number :
Address of Boiler (if different from above)
Town / city
Region :
Postcode :
Make
Boiler/cooker
Rating BTU
First Unit
Second Unit
Year Installed
Last Service Date
Type of fuel
First Unit
Second Unit
Gleaner Boiler Maintenance Charges
I agree to the terms and conditions of this agreement and would like Gleaner Oils Ltd to service my boiler.
Date: