ULSD Diesel Contract Form – Supreme Oil & Service Corp.

ULSD Diesel Contract

1-Address:

Address Line 1

City

State

2-From nearby major road or intersection , how would a driver approach your house?

3-Please give us a brief description of your Yard or Site

4 Where is the tank & Trucks Located?

Tank Size *

Select your Preference

ULSD-CLR
ULSD-RED

Tank Location & Access Code

Yard & Site Manager

Emergency Number

Per Gallon $5.27

Pricing Confirmation *

Please write the price you see per Gallon

Email *

Please check accordingly :

For Will Call Only check here (initials)
For Schedule-auto check here (initials)

Customer is responsible for notifying Supreme Oil & Service at least 2 business days before delivery. Customer agrees that all deliveries will be paid by credit card unless SUPREME OIL & SERVICE agrees to payment by invoice after a credit check. If customer consumes more than 3,000 gallons per week, payment must be made by electronic funds transfer (EFT). Customer agrees to pay all invoices in full within 10 days of being billed. Customer agrees to park all vehicles in one location in close proximity to one another if delivery is made on-site. Customer agrees to pay a late fee when payment is delayed. Customer agrees to pay a late fee when payment is delayed. Customer agrees if the delivery is above the amount of gallons requested, payments of the difference will be made on a monthly basis. 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.

Customer agrees to buy Diesel exclusively from SUPREME OIL & SERVICE and to pay all invoices within 10 days of being billed. Customer understands and agrees a late fee will be incurred when timely payment is not made. Should the account balance exceed $400, SUPREME OIL & SERVICE has the right to stop delivering fuel and servicing equipment until the balance is paid. Customer agrees to notify SUPREME OIL & SERVICE in a timely manner when a change occurs that might affect fuel consumption. If customer’s annual consumption of fuel is less than 1000 gallons, customer agrees that SUPREME OIL & SERVICE has the right to refuse service. Customer agrees if more than one tank exists on customer’s property, whether active or inactive, it is the customer’s responsibility to label all tanks and immediately notify Supreme Oil in writing of same to prevent accidental delivery to the incorrect tank. SUPREME OIL & SERVICE is not responsible for delivery to an incorrect tank unless said tanks are clearly marked, and previous notification of multiple tanks has been provided in writing to Supreme Oil. Customer agrees to clear the path to my storage tank fill pipe during snowy or icy weather (SUPREME OIL & SERVICE drivers are prohibited from shoveling snow or cleaning the path). Customer agrees to pay SUPREME OIL & SERVICE a $150 fee for the unsuccessful delivery due to any obstructed path that prevents fuel delivery. Customer is responsible for measuring the fuel oil levels in the subject storage tank when a snowstorm is on the way. SUPREME OIL & SERVICE is responsible for the delivery of the fuel to the receiving pipe or outlet designated by the customer. Customer agrees that neither SUPREME OIL & SERVICE nor its employees or agents shall be liable under any circumstances for damages resulting from leaks or for the failure of the receiving tank or associated piping, or any other matter. Customer agrees that SUPREME OIL & SERVICE shall not be responsible for previously existing problems of subject heating and/or cooling system(s), no matter when such problems are discovered. Customer agrees that if a problem develops involving any portion of the subject heating and/or cooling system(s), or any consequential damages from that problem that is not explicitly covered by any agreement between SUPREME OIL & SERVICE and customer, that I will seek remedy against other installers or service providers and my own insurance, if any. Where applicable, Customer agrees to work with SUPREME OIL & SERVICE to resolve any problems and agrees to supply proof of damages mitigation for recovering losses, and to provide SUPREME OIL & SERVICE with all pertinent information. If SUPREME OIL & SERVICE commences legal action against customer to recover a debt owed to SUPREME OIL & SERVICE, Customer shall be responsible for any and all expenses associated with the collection of that debt, including but not limited to process service fees, court costs, and attorney’s fees. Customer can terminate this contract at any time. If Customer wishes to terminate said contract with SUPREME OIL & SERVICE, Customer will give a written termination notice to SUPREME OIL & SERVICE with 30 days notice. SUPREME OIL & SERVICE will not be responsible for any damages following any late payment status by Customer. Following SUPREME OIL & SERVICE’s receipt of a written termination notice, any account balance, including my minimum balance, will be returned to customer within 10 days. Such written termination notice shall not affect any right of claim SUPREME OIL & SERVICE has against customer until any and all debts owed to SUPREME OIL & SERVICE are fully paid. SUPREME OIL & SERVICE has the right to terminate my contract for non-payment and/or just cause pursuant to its by-laws. Marinas & Marine Fueling, the company is not responsible for any spill occurred by storm, high tide, low tide customer will assume all responsibility. We certify that the amount of NY State taxes will be paid by us (FT-100) - 15ppm Sulfur (Maximum) Clear Ultra-Low Sulfur Diesel , Dye Ultra Low Sulfur Diesel, Heating Oil #2 and Bio-Fuels.

Signed: *

Print Name *

Date *

For all billing questions, the office is available M-F during work hours 8am-5pm. After hours are for EMERGENCY only. Due to high volume of calls and limited staff, please leave a voice mail, e-mail or text and we will reply in a timely manner. If you need immediate access to your account, please log-in to your account via the Supreme website to view the delivery history, balance due or to make payment.