消火／火災報知設備・休止管理システム

Capturing Language

休止状況

復旧の情報

復旧日:
(mm/dd/yyyy) This question requires a valid date format of MM/DD/YYYY.

calendar

復旧時刻:
(14:15 = 2:15 pm)

担当者名:

連絡先

氏名: *This question is required.

役職名または部署名: *This question is required.

電話番号: *This question is required.

メールアドレス: *This question is required. This question requires a valid email address.

追加連絡先氏名:
*This question is required.

追加連絡先メールアドレス:
*This question is required. This question requires a valid email address.

拠点詳細

御社名（親会社または保険証券上）: *This question is required.

御社名（拠点名、関連子会社など）:

番地 / Street: *This question is required.

市区町村 / City: *This question is required.

都道府県、州: *This question is required.

国名: *This question is required.

休止設備の詳細

24 hrs + Estimated Date of Restoration