Please enable JavaScript in your browser to complete this form.Generator Fueling1-Address:Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState2-From nearby major road or intersection , how would a driver approach your house?3-Please give us a brief description of your Generator, Yard or Site4- Where is the generator located?Please submit a picture of the generator along with the specs. Will need KW per running load. (Usually, this information is located on the door)File Upload Click or drag files to this area to upload. You can upload up to 3 files. Tank Size *Select your PreferenceULSD-CLRULSD-REDGenerator Brand & KWYard & Site ManagerEmergency NumberEmergency NumberPer Gallon $4.3Pricing Confirmation *Please write the price you see per GallonEmail *Please check accordingly :For Will Call Only check here (initials)For Schedule-auto check here (initials) Customer agrees they are responsible for notifying Supreme Oil when in need of fuel at least 2 business days before delivery, Company is not responsible for runs out and power outage. Customer agrees that all deliveries/services will be paid by credit card/ACH unless SUPREME OIL & SERVICE agrees to payment by invoice after a credit check. If Customer consumes more than 1,000 gallons per week, payment must be made by electronic funds transfer (ACH/EFT). Customer agrees to pay all invoices in full within 10 days of being billed. The customer agrees to provide the kilowatts per hours and voltage. Customer agrees to pay a late fee when payment is delayed. Customer agrees if the delivery is above the number of gallons requested, payments of the difference will be made monthly. Additional fees may apply on complex deliveries, after hours deliveries or deliveries below stated minimums. Customer agrees to provide a delivery schedule and description on delivery protocols. Signed: *Clear SignaturePrint Name *Date *Submit Form