sa-glass
 

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Your Details
Name
Tel (incl. area code)
Cell
Fax (incl area code)
Email
Glass, Vehicle and Installation Details
Glass Required

Windscreens
Front Rear

Side glass
Passenger front Passenger rear
Driver front Driver rear

Quarter Glass
Passenger front Passenger rear
Driver front Driver rear

4 X 4 and Bakkies
Canopy glass
Cab slider

Vehicle Make & Model
Preferred Install Date
Address
Payment Method
Payment Method Cash or Insurance Claim
If you have selected Insurance Claim in the above option, please furnish the following details:
Insurance Company Details
Name of Insurance company
Tel No. Insurance Company
Policy Number
Additional Note
Security Question

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Note: No spaces before or after the answer.

 

 

 
Call Centre: 0861 101 400
   
Fax: 086 669 8180
   
info@sa-glass.com
 
PO Box 261314
Excom
2023
 
A/H Emergency Number
082 566 3334