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 Commercial Service
Please complete all spaces below to apply on-line.
Business Account::
Email Address:
Billing Address:
City:
State:
Zip Code: -
Street Address:
City:
State:
Zip Code: -
Business Phone: - -
Contact:
AP Contact:
Check one:

  Corporation
  Partnership
  Sole Proprietorship
Type of Business:
Number of Years in Business:
Do you have an existing tank?

  Yes
  No
Do you own your own tank?

  Yes
  No
What type of fuel do you use?

  Fuel Oil
  K1 Kerosene
  Propane
If propane, what size is your tank?

  200 lb. cylinder
  420 lb. cylinder
  250 gallon tank
  325 gallon tank
  500 gallon tank
  1000 gallon tank
Bank Reference:
First Name:
Last Name:
Telephone Number: - -
Address:
City:
State:
Zip Code: -
Account Number:
Local Trade References:
Company:
Account Number:
Telephone Number: - -
Company:
Account Number:
Telephone Number: - -
Company:
Account Number:
Telephone Number: - -
Estimated Monthly Purchase:

A DEPOSIT MAY BE REQUIRED IF YOUR ACCOUNT CANNOT BE ESTABLISHED THROUGH A CREDIT CHECK. A BLUE RIDGE ENERGIES REPRESENTATIVE WILL CONTACT YOU IMMEDIATELY SHOULD THERE BE A QUESTION IN ESTABLISHING YOUR ACCOUNT.

Comments:
Blue Ridge Energies appreciates your business and looks forward to serving you.

BY SUBMITTING THIS FORM, I CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. BLUE RIDGE ENERGIES, LLC IS AUTHORIZED TO MAKE ANY AND ALL INQUIRIES NECESSARY FOR ACTION ON THIS APPLICATION. I HEREBY INDEMNIFY BLUE RIDGE ENERGIES, LLC AND ITS AGENTS FROM ANY LIABILITY RESULTING FROM THEIR CREDIT SURVEY.

I UNDERSTAND THAT BLUE RIDGE ENERGIES, LLC TERMS ARE NET DUE - 30 DAYS AFTER DELIVERY OF PRODUCT AND AGREE TO MEET THESE TERMS IF CREDIT IS EXTENDED. BY SUBMITTING THIS FORM, I ALSO AGREE TO PAY ANY AND ALL FINANCE CHARGES, PENALTIES, OR COURT COSTS RESULTING FROM THIS ACCOUNT BEING DELINQUENT.

A FINANCE CHARGE OF 1 ½% PER MONTH, WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% WILL BE ADDED ON THE REMAINING UNPAID BALANCE OVER 30 DAYS OLD.

  

 
 
Commercial Service