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Acct#___________Name__________________________
Please be aware you are
purchasing a fixed price contract with your signature below. All deliveries will be made at this price
until you have used up your prepaid allotment and this contract expires on May
31, 2008. This plan has NO down side
protection. Prepaid gallons will be
used first and deliveries at the market price are available only after your
contract gallons are used. Customers
must be on automatic delivery unless arrangements are made with Jeff. As stated on the cover letter, this
contract may be suspended in the event of a supply crisis.
Contract prices are
as follows:
#2 Fuel
$2.579 per gallon Senior Citizen Rate is
$2.539 per gallon
#3 Outside Mix
$2.629 per gallon
Senior Citizen Rate is $2.589
per gallon
Kerosene
$2.999 per gallon
Senior Citizen Rate is $2.959 per gallon
Yes, I am a senior
citizen____ I will be at least 62 years young as of Sept. 1, 2007. DOB___________
Estimated gallons for the 2007-2008 season_______ gallons of #2
#3mix Kero
Estimated yearly cost (gallons x price per gallon) $________= $_________
Less any credit balance as of June 27, 2007 ____________
Actual amount of
check or credit card to cover season $_____________
While we can take your
credit card information on this contract, you may also go to our website www.awpeters.com and make a payment using a
secure site. When asked for an
invoice number, please use your account number (which is on line 1 of this
document) followed by the two digit month and two digit year. For example:
1234X0707
Master Card or Visa only:
CC#_____________________Exp date____/_____
Name as it appears on the
card_____________________________________
The deadline for
purchasing this contract is July 20th, 2007. Contracts are secured by your signature
and receipt of your payment. Prices
are subject to change after this date. If
you need assistance filling out this form, please call Jeff or Wendy at
924-3388. You can also email Jeff at awpeters@monad.net
or wendy@awpeters.com
I agree to purchase
my heating oil only from A.W. PETERS, INC. for the length of this contract and I
understand that this contract may be suspended in the event of a supply crisis.
Your signature is
required to secure this contract.
______________________
Date
of acceptance_______________
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