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Commercial Account Application
In order to establish an account with Capitol Di$count Fuel, you must fill out the form below to apply for an account.  You will receive an email confirmation at the email address you provide and the Customer Service staff will contact you shortly.

* Required field
Type of Business*




 
Company Information
Company Name*
 
Federal Tax ID*
 
Address*
 
City*
 
State*
 
Zip Code*
   
Email Address*
   
Phone (10 digits only, no hyphens)*
   
Other Phone (if applicable. Digits only.)
 
Fax
 
Other Contact Information
Accounts Payable Contact Name*
 
Owner/Partner/Officer
Owner Address (enter full address)
Owner Social Security #
 
2nd Owner/Partner/Officer
2nd Owner Address (enter full address)
2nd Owner Social Security #
 

Has the applicant or any of its ownder, principals, partners, officers or directors ever filed a voluntary petition in bankruptcy, been adjudged bankrupt, or made an assignment for the benefit of creditors?

Credit Investigation Authorization

I hereby authorize Capitol Di$count Fuel to make whatever credit investigations they may deem appropriate and to exchange any information they may receive in the course of such investigations. A copy of this authorization shall be as valid as the original.

1st Guarantor Signature:*
 
2nd Guarantor Signature:*
 
Guarantor's Title:
2nd Guarantor's Title:
Personal Guaranty

In consideration for the extension of credit for the purchase of goods or services to the applicant, THE UNDERSIGNED PERSONALLY GUARANTEES THE UNCONDITIONAL PAYMENT OF ANY UNPAID AMOUNT UPON APPLICANT'S ACCOUNT. This is a guarantee of payment and not merely of collection; no collection-or civil action need be commenced against the Applicant prior to a demand being made upon the undersigned. A copy of this guarantee shall be as valid as the original.

Signature*
 
Service Locations

IF YOUR COMPANY HAS MORE THAN 1 LOCATION BEING SERVICED BY CAPITOL DI$COUNT FUEL PLEASE FILL IN BELOW.
This contract will confirm that Capitol Di$count Fuel will continually provide credit to for various jobs/locations.  By signing this contract you and you company agree to be governed by all the terms and conditions of this contract for any project, job or location to which we provide service.

Credit Policy Terms and Credit Agreement

Credit Policy and Terms

UPON RECEIPT OF INVOICE
A LATE CHARGE will be assessed on balances over 30 days. This is computed by a periodic rate of 1.5% (which is an annual percentage rate of 18%) on the portion of the previous balance over 30 days less payments and credits appearing on the statement. An account is considered PAST DUE when a LATE PAYMENT CHARGE is assessed. Any account which becomes past due may be subject to termination of service WITHOUT NOTICE until the balance is paid in full.

  1. Any account which is turned over to an attorney will be charged with all of Capitol Di$count Fuel attorney fees and costs of collection.
  2. A service charge of $35.00 will be applied when a check is returned by the bank.