Propane Requirements for Tenants

Your account will be set up as a Will Call/Call In account. Please monitor your propane level by lifting the lid of the tank(s) and reading the Sight Gauge under the lid. When the gauge reads 30%, please call our office at the number above to schedule delivery and arrange payment.

Payment for propane delivery by Mastercard, Visa, or online banking must be processed in ADVANCE of your delivery. Your delivery will be made within 5 business days after payment has been processed. Please fill out the form below or email to customerservice@primemaxenergy.com

Remember that it is your responsibility to check the fuel level and prevent any run outs

Business Info
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- Corporation
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Principle/Owner*
Date of Birth*
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DD
YYYY
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Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
HST #*
Amount of Credit Requested*
PO Required*
- Yes
- No
Contact for Account
Name*
First Middle Last
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone*
Cell Phone
Position*
Since*
Month
Day
Year
Trade Reference 1
Name of Reference*
Account # or Name*
Contact Name*
First Last
Phone*
Ext
Trade Reference 2
Name of Reference*
Account # or Name*
Contact Name*
First Last
Phone*
Ext
Trade Reference 3
Name of Reference*
Account # or Name*
Contact Name*
First Last
Phone*
Ext
CREDIT TERMS - NET 20 DAYS - Final Credit Terms to be granted and approved by Primemax Energy Inc.
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- I authorize PRIMEMAX ENERGY INC. to conduct credit checks or obtain any information required to establish or verify my financial standing for the purpose of this credit application. I also agree to comply with the terms and conditions of sale as stated above.

Propane Requirements for Tenants

Business Info

Contact for Account

Trade Reference 1

Trade Reference 2

Trade Reference 3