Please, fill in all data correctly and you will receive our offer within the next two days. You may be contacted by our employees in order to clarify some details if necessary – we want to make sure that our proposal is accurate and proper.

Fields marked with a star (*) are obligatory.

All data submitted in this questionnaire is review in full confidentiality and in compliance with the law for personal data protection.

Organization profile
Organization name: *
ID number (Bulstat): *
VAT id number:
Address (registration): *
Head office address (if different):
Site address (if different):
If the company is part of a group or other structure, please specify:
MD/Chief Executive Officer/General Manager: *
MR/Management Representative: *
Position of MR: *
Phone: *
Mobile:
Fax:
E-mail: *
Other remarks (if necessary):
Desired Certification/ Service: *
Financing of projects for energy efficiency activities with guaranteed results
Energy efficiency investigation of buildings
Technical support and project management for the local self-governing bodies
Creation of local and regional energy agencies with financing through European programs SAVE / CONCERTO and others
Energy efficiency investigation of industrial enterprises
Certification of buildings for energy efficiency with the purpose of assessing and attesting conformity with regulation requirements
Others:
Do you have another certification (management system/product certification)?: YES NO
If, YES, please provide details:
Scope of certification/ Products/ Management system/ Activities / Processes: *
Number of buildings/ industrial halls which will be certified/ investigated (please provide details about: volumes (in cubic meters), annual consumption of electrical energy and heat energy): *
Number of employees: *
Work language (for the audit):
How many work shifts do you have?(Please mark the appropriate)
Shift 1:   Begins:   Ends:
Shift 2:   Begins:   Ends:
Shift 3:   Begins:   Ends:
Shift 4:   Begins:   Ends:
Consulting company/ consultant which took part in investigation/ initial research (if any):

Additional information (if any):
How did you hear about EuroBul Energy?
Customers	Partners
Media/Internet	Others:
Please state the name of the person/s who recommended to you EuroBul Energy:

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