Credit Application

If you would like to apply for credit, please fill out the form below.

* Please note that we are not requesting for your Social Security Number or your Birth Date in the form below - but it is REQUIRED. A representative will give you a call at the phone number you provide to get this information from you and will process the application.

* Denotes Required Field

Name:*

Email:*

Spouse Name:

Present Address:*

County:*

Home Phone:

Work Phone:

Cell Phone:*

Previous Address*

Previous County*

Employer/Address:*

Employer Phone:*

Do You:

Own
Rent

Have you used Propane before?:*

Yes
No

If yes, Supplier:

Name of Co-Signer (if applicable)

Co-Signer Address:

Digital Signature of Applicant:*

Today\'s Date:*

By clicking on the submit button below, you verify that you have read and fully understand the Terms and Conditions of this agreement:

All sales are expressly conditional on Buyer's agreement to the standard terms and conditions hereinafter set forth by Berico Fuels Inc., Alamance Oil Company, Carolina Fuels Inc., or Gateco Oil Company, hereinafter referred to as "Seller". No additional or different terms apply unless expressly agreed upon by Seller. Seller hereby gives notice of its objection to any different or additional terms. The terms and conditions contained herein, once notified, shall be binding upon the initial order and upon all future orders.
Seller and any of its employees, officers or agents hereby are authorized to use the contact information identified in this application to obtain information necessary to review Buyer’s creditworthiness, and Buyer hereby waives any and all claims against, and fully releases from liability and any and all Seller’s parties with the respect to any such inquiry.
The contact information in this agreement authorizes Seller to review information pertaining to the Buyer’s credit history including, without limitation, information regarding Buyer’s loans, accounts, purchases or other financial transactions involving the bank trade references in the past, present and future, and Buyer hereby waives any and all claims against, and fully releases from liability, any such representatives with respect to any such disclosure.
Seller may reject this application in its sole and absolute discretion. Seller may cancel or modify Buyer’s business credit granted as a result of the Application at any time in their sole and absolute discretion.
To secure the full and timely payment by Buyer to Seller of all now existing and hereafter arising amounts due to Seller, Buyer hereby grants to Seller a priority security interest and lien in and to all goods, inventory, equipment and fixtures sold to Buyer by Seller.
In the event Buyer defaults in payment of any invoice, the Buyer will be responsible and will pay such costs as finance charges, administrative fees, collection agency commissions, reasonable attorney fees, and other expenses (including without limitation, at trial and on appeal) as Seller may incur in any manner of collection of any sums past due balances.
In the event of an invoice or accounting error, Seller will abide by The Federal Truth-in-Lending Act. Buyer is to notify Seller of any errors in writing (email accepted), and Seller will respond in a timely manner, not to exceed 30 days acknowledgement of the notification, and 90 days respond to the Buyer’s notification.
If Buyer fails to abide by the Terms of Sale contained herein, then Seller reserves the right to discontinue and eliminate any price discounts, stop shipments or service of products offered to or in place.

BY SUBMISSION OF THIS CREDIT APPLICATION THE BUYER GRANTS PERMISSION TO SELLER TO VERIFY THE INFORMATION CONTAINED IN THIS CREDIT APPLICATION AND AGREES TO THE TERMS AND CONDITIONS CONTAINED THEREIN