Firstname*

    Name*

    Company name*

     

    Are you an owner, purchaser or other?* :

    Other, please specify :

     

    Site address*

    Lot number(s)*

    Nature of activities on the site* :

     

    Presence of previous environmental and/or geological studies?* :

     

    Phone number*

    Secondary phone number

    Do you allow our staff to leave a message or introduce themselves during communications?* :

     

    Email*

    Billing address*

     

    Is it a sale, a purchase, request for financing or other? * :

    Other, please specify :

     

    Additional info :