Quote Me

Fill out the following and we will send you an estimated installation and operating cost compared to fossil fuel type systems. E-mail: bposch5@eml.cc or fax 248-634-7579

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BUILDING INFORMATION SHEET

First & Last Name_____________________________________

Address___________________________________

City___________________State____________________Zip______________

Phone____________________Fax__________________________

Heating contractor, name & phone number:

Our electric utility phone number is_________________________________________

House square footage: Upper_________Main___________Lower_____________

What portion of the lower (basement) is living area.__________________Sq. Ft.

I will be heating a total of ____________________Sq. Ft.

If you know the R factors of your walls & ceiling, that’s all we need. If you are not sure, describe the kind of insulation in the walls & ceiling and how thick is it?

Walls________________________Ceiling_______________________

My basement is/is not insulated?__________________If yes, what with?___________________________

Is it a walk-out?__________________

Number of windows and glass door walls in the house.: [] Average [] Below average [] Above average

My lot size is______________________________What is your water source? [] Well [] Municipal

When do you plan to break ground?________________________________________________

What type of soil is on your lot? [] clay [] sand [] gravel etc. Please describe.

Are you familiar with the Stainless Steel Hydron geothermal heat pump? [] yes []no