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 Master Card/Visa/Debit, 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

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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
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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