Client Questionnaire – Efficient Automation

First Name

Last Name

ID Number

Home Number

Cell Number

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Broker Details

Hollard Policy Number

Billing Address

Mark as Same as Physical

Billing Address Details

Address Line 1

Address Line 2

City

State

Zip Code

Country

Is your property Single Phase or Three Phase?

Single Phase

Three Phase

I don’t know

Choose your Option

Would you like to use your own electrician to install your surge protector?

Would you like a Hollard-approved electrician to install your surge protector? (Gauteng only) This comes at a fee of R1,390 (excluding VAT) which includes installation and the receipt of a supplementary Certificate of Compliance (CoC).

Please note that at the moment, we only service Gauteng. If your residence is not located in Gauteng, we will not be able to assist you with the installation of your surge protector.

Thank you for electing a Hollard-Approved Electrician. Please take note of, and accept, the following Terms & Conditions:

An electrician will be assigned to install your surge arrester.
A certified electrician will make contact with you within the next 7 – 14 working days to arrange a time for installation.
In the event the electrician has made three attempts to contact you unsuccessfully, the electrician reserves the right to abort the project. (You will be charged in this scenario.)
It is your responsibility to ensure the surge protector device arrives before confirming a time for installation with the electrician.
If you arrange a time for the electrician and the device has not arrived or is missing, the electrician call out fee of R1,390 (excl. VAT) will be charged in full.
Please note that if you arrange a time with the electrician and the electrician is prevented from entry or no-one is available to open for them, the installation fee of R1,390 (excl. VAT) will be charged in full.
If you decide to re-schedule with the electrician after their arrival, you will be charged the fee of R1,390 (excl. VAT) in full.
It is your responsibility to ensure your DB board is compliant and has requisite space for the installation of the surge protector device. If the electrician arrives and your DB board is not compliant or there is not enough space for the surge protector, you will be charged the fee of R1,390 (excl. VAT) in full. You will need to privately arrange for an electrician to re-wire your DB board to ensure compliance. This will be a private arrangement between yourself and the electrician.

Please use the provided buy now button to add your installation below:

R1,390.00Add to cart

I confirm my installation address falls within Gauteng

I understand that the surge arrestor needs to be delivered before I can confirm an installation date with the electrician

Yes

Please choose your Option

Would you like to use your own electrician to determine which phase you on?

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