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Your Name *
Contact Number
E-mail Address
Address
Manufacturer:
Model
KW Rating
Date Installed
Expiry Date of Warranty
Is a maintenance contract in force?*
If Yes please provide details
Location Address (inc. Postcode)
Electrical installation: (Direct to Grid or through a distribution transformer)
Proposed Maintenance program for the distribution transformer (if applicable)
Please provide details of any losses sustained during the last 5 years, whether insured or not
Who is the current insurer in respect of this site?
Equipment Description
Turbine Manufacturer and Model
KW
Year Installed
Physical Damage
Number of Units
Value Per Unit
Total Value
Loss of Revenue
Revenue Per Unit
Total Revenue