Delivery Form

You can order by Call OR Email

*=Required






 Email Mail

Contact Information





 Month to Month One Year (Ask for specials)

Bottled Water

CI $6.00 per 5 gallon, CI $10.00 deposit per bottle



CI $4.00 per 3 gallon, CI $6.00 deposit per bottle



If it is anticipated that more bottles will be required for the following delivery cycle, the Customer may order online, by phone and/or through the delivery driver at the time of delivery.
For any additional bottles, the deposit must have been paid in advance or at time of delivery for the order to be processed, unless the Customer has provided a Direct Debit authorisation.


 Yes No

 Lease: CI $10.00 / Month (6 month prepayment required CI $60.00) Purchase: CI $200.00



 Lease: CI $15.00 / Month (6 month prepayment required CI $90.00) Purchase: CI $250.00







(Allows only .txt, .jpg, .jpeg, .png, .gif, .pdf, .docx, .doc, .odt, .xls, .zip files)
I agree to Terms & Conditions

*=Required






 5 GALLON
 DISPENSER RENT PURCHASE

Order Now