Free Quote Form

Name

E-mail

Date Req

Time Req

Client

Order No

Property

Phone No

UHF No

Ordered By

Mobile No

Fax No

Field Number	Hectares	Product	Rate/HA	Water Rate/HA	Product Required

Add Field Delete Field

Product Supplier

Crop

Please Tick Appropriate Box

1. Will chippers or field workers be present?

Yes

2. Have chippers and field workers been Notified?

Yes

3. Your neighbors need to be Notified. Have you done this?

Yes

4. Will your neighbors have field workers present?

Yes

5. Are there any special considerations for any of the following?

Yes

Susceptible crops

Yes

Pastures

Yes

Houses

Yes

Roads

Yes

Stock routes

Yes

Grazing stock

Yes

Grazing land

Yes

Rivers

Yes

Waterways

Yes

Fences

Yes

Power wire

Yes

6. If you have answered "yes" to any of the above, please give details:

7. Are there any other environmental considerations or special instructions?

IN SUBMITTING THIS FORM I UNDERSTAND THAT THIS DOES NOT CONSTITUTE A BINDING CONTRACT AND DOES NOT OBLIGE RURAL AIR WORK PTY LTD TO CARRY OUT THE REQUESTED WORK. PLEASE PHONE TO CONFIRM THAT YOUR REQUEST HAS BEEN RECEIVED.