Information request form
Items
whith
a
sterisks
are mandatory
*
Category of the application:
Agricultural
Commercial
Industrial
Pumping
Other
*
Summary description of the application to be controlled:
Information:
*
Full
Name:
*
Title:
*
Company name:
*
Address:
*
City:
*
Province:
*
Postal/ZIP Code:
(ex: J2C 3T2)
*
Phone:
(ex: (819)478-8886)
Fax:
(ex: (819)478-8886)
*
E-mail:
Multico Électrique inc.
1000, Bergeron Drummondville (Québec) Canada J2C 0C1
Phone : (819) 477-6777 Fax : (819) 478-0198
E-mail :
multico@multicoelectric.com
