Coordinates

Is the intervention carried out on behalf of a company ? *

No

Yes

Gender *

Mr

Mrs

Lastname & Firstname *

Social reason

Phone *

E-mail *

Date

Does delivery have to take place on a specific date ? *

Yes

No

Delivery date *

From *

To *

Delivery

Wich type of material would you like to have delivered ? *

Kitchen Sofa Furniture Desk Bathroom Other

Do you need an installation service ? *

No

Yes

Address

Country *

Aruba Afghanistan Angola Anguilla Åland Albania Andorra United Arab Emirates Argentina Armenia American Samoa Antarctica French Southern Territories Antigua and Barbuda Australia Austria Azerbaijan Burundi Belgium Benin Bonaire Burkina Faso Bangladesh Bulgaria Bahrain Bahamas Bosnia and Herzegovina Saint Barthélemy Belarus Belize Bermuda Bolivia Brazil Barbados Brunei Bhutan Bouvet Island Botswana Central African Republic Canada Cocos [Keeling] Islands Switzerland Chile China Ivory Coast Cameroon Democratic Republic of the Congo Republic of the Congo Cook Islands Colombia Comoros Cape Verde Costa Rica Cuba Curacao Christmas Island Cayman Islands Cyprus Czech Republic Germany Djibouti Dominica Denmark Dominican Republic Algeria Ecuador Egypt Eritrea Western Sahara Spain Estonia Ethiopia Finland Fiji Falkland Islands France Faroe Islands Micronesia Gabon United Kingdom Georgia Guernsey Ghana Gibraltar Guinea Guadeloupe Gambia Guinea-Bissau Equatorial Guinea Greece Grenada Greenland Guatemala French Guiana Guam Guyana Hong Kong Heard Island and McDonald Islands Honduras Croatia Haiti Hungary Indonesia Isle of Man India British Indian Ocean Territory Ireland Iran Iraq Iceland Israel Italy Jamaica Jersey Jordan Japan Kazakhstan Kenya Kyrgyzstan Cambodia Kiribati Saint Kitts and Nevis South Korea Kuwait Laos Lebanon Liberia Libya Saint Lucia Liechtenstein Sri Lanka Lesotho Lithuania Luxembourg Latvia Macao Saint Martin Morocco Monaco Moldova Madagascar Maldives Mexico Marshall Islands Macedonia Mali Malta Myanmar [Burma] Montenegro Mongolia Northern Mariana Islands Mozambique Mauritania Montserrat Martinique Mauritius Malawi Malaysia Mayotte Namibia New Caledonia Niger Norfolk Island Nigeria Nicaragua Niue Netherlands Norway Nepal Nauru New Zealand Oman Pakistan Panama Pitcairn Islands Peru Philippines Palau Papua New Guinea Poland Puerto Rico North Korea Portugal Paraguay Palestine French Polynesia Qatar Réunion Romania Russia Rwanda Saudi Arabia Sudan Senegal Singapore South Georgia and the South Sandwich Islands Saint Helena Svalbard and Jan Mayen Solomon Islands Sierra Leone El Salvador San Marino Somalia Saint Pierre and Miquelon Serbia South Sudan São Tomé and Príncipe Suriname Slovakia Slovenia Sweden Swaziland Sint Maarten Seychelles Syria Turks and Caicos Islands Chad Togo Thailand Tajikistan Tokelau Turkmenistan East Timor Tonga Trinidad and Tobago Tunisia Turkey Tuvalu Taiwan Tanzania Uganda Ukraine U.S. Minor Outlying Islands Uruguay United States Uzbekistan Vatican City Saint Vincent and the Grenadines Venezuela British Virgin Islands U.S. Virgin Islands Vietnam Vanuatu Wallis and Futuna Samoa Kosovo Yemen South Africa Zambia Zimbabwe

City *

Region *

Address *

Number

Accessiblity

The parking space

Is reserved for this accommodation ?

Is located in a blue zone ?

Requires parking permit ?

Presents other access difficulties (stairs, far from accommodation)

Address

Country *

Aruba Afghanistan Angola Anguilla Åland Albania Andorra United Arab Emirates Argentina Armenia American Samoa Antarctica French Southern Territories Antigua and Barbuda Australia Austria Azerbaijan Burundi Belgium Benin Bonaire Burkina Faso Bangladesh Bulgaria Bahrain Bahamas Bosnia and Herzegovina Saint Barthélemy Belarus Belize Bermuda Bolivia Brazil Barbados Brunei Bhutan Bouvet Island Botswana Central African Republic Canada Cocos [Keeling] Islands Switzerland Chile China Ivory Coast Cameroon Democratic Republic of the Congo Republic of the Congo Cook Islands Colombia Comoros Cape Verde Costa Rica Cuba Curacao Christmas Island Cayman Islands Cyprus Czech Republic Germany Djibouti Dominica Denmark Dominican Republic Algeria Ecuador Egypt Eritrea Western Sahara Spain Estonia Ethiopia Finland Fiji Falkland Islands France Faroe Islands Micronesia Gabon United Kingdom Georgia Guernsey Ghana Gibraltar Guinea Guadeloupe Gambia Guinea-Bissau Equatorial Guinea Greece Grenada Greenland Guatemala French Guiana Guam Guyana Hong Kong Heard Island and McDonald Islands Honduras Croatia Haiti Hungary Indonesia Isle of Man India British Indian Ocean Territory Ireland Iran Iraq Iceland Israel Italy Jamaica Jersey Jordan Japan Kazakhstan Kenya Kyrgyzstan Cambodia Kiribati Saint Kitts and Nevis South Korea Kuwait Laos Lebanon Liberia Libya Saint Lucia Liechtenstein Sri Lanka Lesotho Lithuania Luxembourg Latvia Macao Saint Martin Morocco Monaco Moldova Madagascar Maldives Mexico Marshall Islands Macedonia Mali Malta Myanmar [Burma] Montenegro Mongolia Northern Mariana Islands Mozambique Mauritania Montserrat Martinique Mauritius Malawi Malaysia Mayotte Namibia New Caledonia Niger Norfolk Island Nigeria Nicaragua Niue Netherlands Norway Nepal Nauru New Zealand Oman Pakistan Panama Pitcairn Islands Peru Philippines Palau Papua New Guinea Poland Puerto Rico North Korea Portugal Paraguay Palestine French Polynesia Qatar Réunion Romania Russia Rwanda Saudi Arabia Sudan Senegal Singapore South Georgia and the South Sandwich Islands Saint Helena Svalbard and Jan Mayen Solomon Islands Sierra Leone El Salvador San Marino Somalia Saint Pierre and Miquelon Serbia South Sudan São Tomé and Príncipe Suriname Slovakia Slovenia Sweden Swaziland Sint Maarten Seychelles Syria Turks and Caicos Islands Chad Togo Thailand Tajikistan Tokelau Turkmenistan East Timor Tonga Trinidad and Tobago Tunisia Turkey Tuvalu Taiwan Tanzania Uganda Ukraine U.S. Minor Outlying Islands Uruguay United States Uzbekistan Vatican City Saint Vincent and the Grenadines Venezuela British Virgin Islands U.S. Virgin Islands Vietnam Vanuatu Wallis and Futuna Samoa Kosovo Yemen South Africa Zambia Zimbabwe

City *

Region *

Address *

Number

Accessiblity

The parking space

Is reserved for this accommodation

Is located in a blue zone

Requires parking permit

Presents other access difficulties (stairs, far from accommodation)

Accomodation

Accomodation type *

House Flat Collocation Box Office

Wich floor are the offices on? *

Does the accommodation have several levels ? *

No

Yes

Does the accommodation have an elevator? *

No

Yes

Is the product to be delivered located on an upper floor?

No

Yes