The Ordering
The ordering
With the first order all spaces need to be filled                            
With the second only the bold letters spaces need to be filled

The full name of the company: 
NIP:         The orderer’s name and surname:
The Post Office code:   City:   Street, flat:
Telephone number:         Fax:     
Mobile phone number:        E-mail:

I order mineral water in reservoir:
20 (22) litres with a tap – piece:      18,9 litres - piece:               Delivery time  from   to      or    from  to  
To the:        Office     Home     Store      Different place, address:  

 I agree for using my personal details for marketing purposes (due to the personal details security bill dated 19.08.1997 Dz.U.Nr 133 Poz 883).
Recommend the "GeoWodal"® company to friends and cooperative companies, efficaciously and You will get the doser installation and the water ABSOLUTELY FREE.

Recomending person details:    
Telephone number:      Mobile phone number:      E-mail:  

 I agree for using my personal details for marketing purposes (due to the personal details security bill dated 19.08.1997 Dz.U.Nr 133 Poz 883).

New Client’s
personal details:

Telephone or mobile phone number:        E-mail:

 I agree for using my personal details for marketing purposes (due to the personal details security bill dated 19.08.1997 Dz.U.Nr 133 Poz 883).

                        We purchase:     - Water Cooler's (Water Dispenser's) by parts or the complete working (and others installations),
                                                       - close, used or new reservoirs 18,9 litres and 20 (22) litres with a tap,
                                                       - water cocks - ballcock, angular, broken (washing-machine, flush) - 1/2 inch x 1/2 inch, diameter: 20 mm.

Płacimy za bazę danych firm zaopatrujących się w wodę w systemie zbiorników o pojemności 18,9 litra (19 litrów) i 20 (22) litrów.
 
"GeoWodal"® mgr MAREK WOŁK-ŁANIEWSKI    57-300 KŁODZKO ul. Zajęcza 3   tel./fax 074 8659394   mobile phone 0692427286,  0606831673