Commercial Service & Delivery Application

Apply for Commercial Fuel Service & Delivery

Apply for commercial fuel service and delivery online by completing the application below. If you have questions or to request a paper copy please contact our office at 910-944-2329. If you would like to apply for residential service please click the button to the right.

Apply for Residential Service

COMMERCIAL SERVICE APPLICATION

*Name of Firm

*Name / Officer of the Firm

*Email

*Phone Number

*Mailing Address

Mailing Address Line 2

*City

*State

*Zip Code

Kind of Business

Year Established

*Is the business incorporated?

Yes

Name of Officers or Owner of Firm

Current Fuel Supplier

*Supplier Name

*Phone Number

*City

*State

Account No.

Other Business References

*Reference 1 - Name

*Reference 1 - Phone Number

*Reference 1 - City

*Reference 1 - State

Reference 1 - Account No.

*Reference 2- Name

*Reference 2- Phone Number

*Reference 2 - City

*Reference 2- State

Reference 2 - Account No.

TERMS: Net due upon receipt of invoice. A Service charge of 1.5% per month, a rate of 18% annually, will be assessed on accounts over 30 days old. The undersigned official, to induce the granting of credit to the above firm, hereby personally guarantees the company's credit.

Information Verification and Delivery Authorization (Please read before signing):

The above information is for the purpose of obtaining service / credit and is warranted to be true. I hereby authorize with information I provided a credit check can be obtained. I have read and agree to the terms and conditions of this service application.

I will personally guarantee any debt incurred on the account stated above.

Terms and Conditions

*Terms & Conditions

I agree to the terms and conditions of this agreement.

*Signature