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Client Information
Company Name
Trading Name
Department
Registration Number
VAT Number
Title
Mr.
Ms.
Mrs.
Dr.
Other
Initials
Surname
ID Number
VAT Number
Contact Number
Email Address
Physical Address
Account Information
Surname Of Account Holder
Title
Mr.
Ms.
Mrs.
Dr.
Other
Initials Of Account Holder
Job Title Of Account Holder
Division Responsible For Account
Billing Email Address
Billing Contact Number
Equipment Information
Site Name
Langerand
Karma
Platberg
Floor Space
9U Floorspace @ R1150.00
24U Floorspace @ R2200.00
Equipment Size 1
30cm @ R1100.00
60cm @ R1700.00
90cm @ R2300.00
Standard Sector @ R1700.00
Large Sector @ R3400.00
Equipment Quantity 1
Equipment Size 2
None
30cm @ R1100.00
60cm @ R1700.00
90cm @ R2300.00
Standard Sector @ R1700.00
Large Sector @ R3400.00
Equipment Quantity 2
Equipment Size 3
None
30cm @ R1100.00
60cm @ R1700.00
90cm @ R2300.00
Standard Sector @ R1700.00
Large Sector @ R3400.00
Equipment Quantity 3
Equipment Size 4
None
30cm @ R1100.00
60cm @ R1700.00
90cm @ R2300.00
Standard Sector @ R1700.00
Large Sector @ R3400.00
Equipment Quantity 4
Equipment Size 5
None
30cm @ R1100.00
60cm @ R1700.00
90cm @ R2300.00
Standard Sector @ R1700.00
Large Sector @ R3400.00
Equipment Quantity 5
Generator Fee
Standby Generator Fee @ R550.00
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T's & C's
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