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Please fill in this form and we will contact you.
YES, I would like Automatic Delivery. NO, I will call for my Delivery.
Name and Billing Address:
Shipping Address:
Home Phone: Work Phone: E-mail Address:
Employer: Position: Employer's Address
Date Delivery Required
What type of system do you have? Hot Air Hot Water Boiler Summer/Winter Hookup Steam
What size tank? 275 gal. 330 gal. 550 gal. 1000 gal.
How many gallons?
Where is your tank located? Underground Above Ground Basement
Looking at the front of my house, the tank is located:
Do you want Tank Protection? Yes No
I understand that our first fuel oil delivery will be C.O.D. I have READ and AGREE to the Delivery and Payment Agreement
Leaving Payment If you plan on leaving us payment, please indicate where. Yes, I will leave a payment for delivery If so, where:
Charge Your Account Please contact me to open an account
Additional Info
