613-354-6505
Bulk Fuel Delivery | Lubricants | Heating & Cooling Equipment | CardLock / PetroVend     
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COMMERCIAL ACCOUNT APPLICATION
Company Name:
Billing Address:
City:
Postal Code:
Telephone:
Fax:
GST #
PST #

A/P Contact Name and Tel:

Purchase Order Required? Yes
CREDIT INFORMATION
Type of Business : Incorporated Limited Partnership
Name of Bank Address:
Trade Reference #1
Trade Reference #2
Trade Reference #3
DELIVERY / SERVICE INFORMATION
Exact Delivery Instructions :

FUEL TYPE REQUEST
Furnace Oil Stove Oil Clear Diesel
Coloured Diesel Gasoline 		Tank Size:
Tank Fill Location:
Contact Name On Site: On Site Phone Number:
Additional Comments or Requests:
CREDIT TERMS: 2% per month on accounts over 30 days. (24% per Annum). Accounts with balances over 60 days past due will be placed on C.O.D. until outstanding balance is paid.
Leave original invoice on site? Forward Invoice to Office Other

I agree that McKeown and Wood may obtain credit information as deemed necessary to establish a credit account with this company (Please type yes or no)