<h1>Request a quote</h1><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p>Please fill out the rest of the quote form below and send it by clicking on the button.</p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p> </p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><form name="calculator" id="calculator" action="/quote-request-sent/?lang=en" method="post"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><style><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->td {<!-- [et_pb_line_break_holder] --> background-color: #c8c8c8;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table style="text-align: left; width: 100%;"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tbody><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td width="25%">Location*:</td><!-- [et_pb_line_break_holder] --><td width="75%"><select id="locatie" name="locatie" style="width: 100%;"><!-- [et_pb_line_break_holder] --> <option value="info@opslagboxeersel.nl" selected>Leeuwarden</option><!-- [et_pb_line_break_holder] --> <option value="info@opslagboxmarum.nl">Marum</option><!-- [et_pb_line_break_holder] --> <option value="amsterdamwest@allsafe.nl">Amsterdam West</option><!-- [et_pb_line_break_holder] --> <option value="amsterdamzuid@allsafe.nl">Amsterdam Zuid</option><!-- [et_pb_line_break_holder] --> <option value="amsterdamcentrum@allsafe.nl">Amsterdam Centrum</option><!-- [et_pb_line_break_holder] --> <option value="beverwijk@allsafe.nl">Beverwijk</option><!-- [et_pb_line_break_holder] --> <option value="utrecht@allsafe.nl">Utrecht</option><!-- [et_pb_line_break_holder] --> <option value="almere@allsafe.nl">Almere</option><!-- [et_pb_line_break_holder] --> <option value="tilburg@allsafe.nl">Tilburg</option><!-- [et_pb_line_break_holder] --> <option value="breda@allsafe.nl">Breda</option><!-- [et_pb_line_break_holder] --> <option value="roosendaal@allsafe.nl">Roosendaal</option><!-- [et_pb_line_break_holder] --> <option value="denbosch@allsafe.nl">Den Bosch</option><!-- [et_pb_line_break_holder] --> <option value="leiderdorp@allsafe.nl">Leiderdorp</option><!-- [et_pb_line_break_holder] --> <option value="rotterdam@allsafe.nl">Rotterdam</option><!-- [et_pb_line_break_holder] --> <option value="info@loods038.nl">Zwolle</option><!-- [et_pb_line_break_holder] --></select></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>First name*:</td><!-- [et_pb_line_break_holder] --><td><input id="voornaam" name="voornaam" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Surname*:</td><!-- [et_pb_line_break_holder] --><td><input id="achternaam" name="achternaam" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Address:</td><!-- [et_pb_line_break_holder] --><td><input id="adres" name="adres" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Postal code:</td><!-- [et_pb_line_break_holder] --><td><input id="postcode" name="postcode" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>City*:</td><!-- [et_pb_line_break_holder] --><td><input id="woonplaats" name="woonplaats" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>E-mail*:</td><!-- [et_pb_line_break_holder] --><td><input id="emailx" name="emailx" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Telephone*:</td><!-- [et_pb_line_break_holder] --><td><input id="telefoon" name="telefoon" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>M³ needed:</td><!-- [et_pb_line_break_holder] --><td><input id="m3" name="m3" type="text" style="width: 100%;" value=""></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->document.getElementById("m3").value = volume;<!-- [et_pb_line_break_holder] --></script><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Period*:</td><!-- [et_pb_line_break_holder] --><td><select id="periode" name="periode" style="width: 100%;"><!-- [et_pb_line_break_holder] --> <option value="Niet opgegeven" selected>Make a choice</option><!-- [et_pb_line_break_holder] --> <option value="1 month">1 month</option><!-- [et_pb_line_break_holder] --> <option value="2 months">2 months</option><!-- [et_pb_line_break_holder] --> <option value="3 months">3 months</option><!-- [et_pb_line_break_holder] --> <option value="6 months">6 months</option><!-- [et_pb_line_break_holder] --> <option value="12 months or longer">12 months or longer</option><!-- [et_pb_line_break_holder] --></select></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td>Effective date:</td><!-- [et_pb_line_break_holder] --><td><input id="ingangsdatum" name="ingangsdatum" type="text" style="width: 100%;"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td style="vertical-align: top;">Queries / comments:</td><!-- [et_pb_line_break_holder] --><td><textarea id="vragen" name="vragen" style="width: 100%; height: 150px;"></textarea></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td> </td><!-- [et_pb_line_break_holder] --><td style="text-align: left;"><input value="Send" type="submit" class="et_pb_contact_submit et_pb_button"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td> </td><!-- [et_pb_line_break_holder] --><td>* Mandatory fields</td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></tbody><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></form>