* Name of the M/Y:
* Kind of M/Y: Select pleasure private use pleasure commercial use commercial business use
* Flag:
Captain:
Tel/Fax Captain:
E-mail Captain:
Agency:
Resp. Agency:
Tel/Fax Agency:
E-mail Agency:
Fuel requirements: Select Commercial Fuel Export fuel for dest. extra UE Domestic diesel Domestic Gasoline
Quantity:
Required date:
Required hour : Select 09:00 10.00 11.00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00
Requirement: Select Shell Rimula 15W 40 Shell Rimula 40 Shell Hydrolic Tellus 32/46 Agip sigma turbo 15 W 40 Agip Hydraulic OSO 46 /68 Agip Super diesel 15 W 40
Message:
Aspiration and cleansing of bilges
Aspiration, cleansing and decontamination of fuel tanks
Cleansing of sewage &fresh water tank
Extraction of waste oils
Date:
Hour: Select 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00
Private: Visa, Mastercard, American Express, Diners Club, Cartasì.
Agency: Bank Swift
The personal information you supply will be used by Servizio Mare as permitted by Italian Data Protection law n. 675 of 31.12.1996, and will only be used in connection with Servizio Mare business.
I accept :
