Synergy Contract Enquiry Form Synergy Contract Enquiry Form Please note that this form does not constitute any agreement, it is designed to help assess an application for the Synergy Contract scheme only. The "Owner" and financer will be a finance company called Shire Leasing which is entirely separate from the Synergy Grill. * Must be completed. Section 1 - About you Full Name * Business Name * Business Address * Postcode * Email * Phone Business Type * Limited Company plc Domestic use VAT Number (If applicable) Company Registration number or Charity number (If applicable) Number of years, business has been trading * 1 2 3 4 5 6 7 8 9 10 or More Home Address (If Sole Trader) How did you hear about Synergy Grill? If through one of the Synergy Grill Partners, what is their partner code? Section 2 - About your new Synergy Grill What grill do you require * Synergy Trilogy ST600 (600 wide) Synergy Trilogy ST900 (900 wide) Synergy CGO600 (600 wide with lid) Synergy CGO900 (900 wide with 2 lids) Synergy CGO900DUAL (900 wide with 1 lid) Synergy Trilogy ST1300 (1300 wide) Synergy Trilogy ST1700 (1700 wide) Synergy Trilogy ST600E (600 wide) Synergy Trilogy ST900E (900 wide) Synergy CGO600E (600 wide with lid) Synergy CGO900E (900 wide with 2 lids) Do you need any accessories? * Yes No Accessories Resting Shelf Griddle Plate (ST Range only) 260mm Wide Griddle Plate (ST Range only) 390mm Wide Wok (ST Range only) Rotisserie (ST Range only) Divider Plate Would you require a stand? * Yes No If no, what are you placing the grill on? Do you require Natural Gas, LPG or Electric? * Natural Gas LPG Electric Do you have an old grill that needs to be removed? (Maximum Size we can remove is 1704mm x 540mm x 705mm) * If Yes Complete Section 3 Yes No Section 3 - About removing your old equipment Location of existing unit (e.g. main kitchen, 3rd floor pantry etc): Same location for new install? If not, new install location: Yes No Existing item make: Existing item model: Existing item dimensions (WxDxH): Is existing unit part of a suite? Yes No Is existing item gas (LPG or NG) or electric? Natural Gas LPG Electric Section 4 - About installing your new Synergy Grill Do you require the free installation of your new grill? * If yes, please complete this section, if no, go to section 6 Yes No Is new installation point completely under canopy? Please note, additional charges may apply if no Yes No If ordering an electric grill do you have 3 phase 16amp power supply? Yes No Is the gas supply size available at location of install correct? (i.e. ¾” iron)? Please note, additional charges may apply if no Yes No Is the gas supply bayonet within 1.5M of installation point? Please note, additional charges may apply if no Yes No Is electrical 13 amp supply available within 1.5 metres of grill install location? Please note, additional charges may apply if no and must not be connected to an extension lead Yes No Does installation have sufficient permanent Make Up Air? Please note, additional charges may apply if no Yes No Is Installation interlocked and working (not bypassed)? Please note, additional charges may apply if no Yes No Section 5 - Access Please advise MAX space available for new unit (WxDxH): Floor of Installation (e.g. 2nd floor): Please note, additional charges may apply if requiring a 2 man delivery and installation Ground Floor 1st Floor 2nd Floor or Higher How many flights of stairs to manoeuvre equipment: Please note, additional charges may apply if requiring a 2 man delivery and installation 0 1 2 3 4 5 6 7 8 9 10 or more Lift available? Yes No Number of doorways to manoeuvre through: Please note, additional charges may apply if requiring a 2 man delivery and installation 1 2 3 4 5 6 7 8 9 10 or more Number of turns while manoeuvring equipment: 1 2 3 4 5 6 7 8 9 10 or more Times to avoid/access restrictions: Is parking available on site? Yes No If no, details of nearest parking and costs: Section 6 - Other information Is there any further information you feel would be useful for our engineers to know about the installation? Yes No If yes, please write here Terms & Conditions * Accept Synergy Terms & Conditions * Click Here to read our Privacy Policy or Here to read our Terms & Conditions Submit Interested? Find out more and arrange a FREE demonstration today Contact Us FollowFollowFollowFollowFollow Promoting Environmental Responsibility ✓