To whom it may concern,

I wish to have Niagara Environmental Water Solutions present itself at my home in order to enter into an agreement regarding the supply and installation of water and/or air treatment equipment and I authorize the seller or its finance agents to perform necessary credit checks necessary to obtain credit approval. For this purpose, I ask that an employee contact me in order to set a date and time when the company will present themselves to my home.

I can be reached at the following :




By signing this form and clicking on the send button, I hereby request that Niagara Water Solutions attend at my home the purpose of entering into an agreement for the supply of water and/or air treatment equipment.