Heating Propane Contract Request Form

This Contract Request is for the sale of propane from Frontier Cooperative to the Buyer identified below.

* Indicates Required Field

*Customer Name:

*Contact number

*Address:

*City:

*State:

*ZIP code:

*Delivery address if different than billing address

If same address, put N/A

Cell phone number:

Email:

*Contract Type (Select one):

PREPAY CONTRACT PRICE/GALLON: Gallons to contract (Specify below) x Price Per Gallon (Office Use Only) + Taxes (Office Use Only) = Total Amount (Office Use Only). Please take into account your Summer Fill gallons which are separate from the contract when determining how much to contract. Contract delivery period: September 1 through March 31. FIXED CONTRACT PRICE/GALLON: Gallons to contract (Specify below) x Price Per Gallon (Office Use Only) + 20 cents/Gallon Deposit = Total Amount (Office Use Only). A deposit of 20 cents/gallon is due in order to “LOCK IN” price. Contract delivery period: September 1 through March 31. BUDGET PROPANE FIXED PRICE/GALLON: Gallons to contract (Specify below) x Price Per Gallon (Office Use Only). After you send in your request for gallons we will send you a coupon book with your monthly payment. Eleven equal payments due monthly June 20 through April 20.

*Number of gallons to contract

Security code

TERMS OF PURCHASE:

By entering into this contract, Buyer authorizes Frontier Cooperative to fill the propane tank at their discretion, for the length of the contract period.
Buyer will help minimize run-outs by monitoring tank volume.
Buyer’s account balance must be current at the time of executing the contract and at all times during the term of the contract. Frontier Cooperative has the right to terminate the contract at any time due to non-payment of account balance due.
In the event of non-payment, all remaining amounts due for the delivered number of gallons shall become immediately due and payable. Frontier Cooperative may terminate the contract and/or initiate action to recover its damages resulting from the failure of Buyer to perform under the Contract. Please contract only the number of gallons you expect to use.
Frontier Cooperative is not obligated to deliver any propane on past due accounts.
Deliveries will automatically be made to contract customers by Frontier Cooperative on a regular basis during the Terms of the Contract provided Frontier Cooperative wholesale contracts are honored by its suppliers.
Upon termination of contract, Buyer may be required to make payment to Frontier Cooperative for unused contracted gallons for the difference between the contract price and the market price if the market price is lower than contract price.
The scheduled delivery program utilizes an estimation system based upon prior usage and the recent temperatures. Please help monitor your tank so you do not run out of propane.
Budget Contracts-we reserve the right to adjust the monthly payment if Buyer is not using product as estimated.

PREPAY CONTRACT: Entire amount is to be paid upon signing the contract. Contract delivery period:
September 1 through March 31. NE sales tax (5.5%) (you may have an additional city tax) will be included with prepayment. We will deliver a summer fill to credit-approved customers that is separate from the contract if the tank has space. Please contract gallons accordingly. You will be on an automatic fill program unless other arrangements are approved.

FIXED PRICE CONTRACT: A deposit of 20 cents/gallon is due in order to “LOCK IN” the price. Contract delivery period: September 1 through March 31. Your deposit of .20 per gallon will be applied to each delivery. We will deliver a summer fill to credit approved customers that is separate from the contract if your tank has space, please contract gallons accordingly. You will be on an automatic fill program (if credit approved) unless other arrangements are made.

BUDGET PROPANE PROGRAM: Eleven equal payments due monthly June 20 through April 20.
Monthly payments are due by the 20^th of each month. First monthly payment is due June 20. Once signed up for the Budget Contract, you will receive a coupon book with 11 coupons noting your monthly payment amount each month, based on prior usage. If monthly payments are missed, you will be taken off contract and switched to a call-in customer, and will need to call to order propane and arrange payment. You will receive a delivery at the special summer fill price if your tank has space that will be included in the budget. You will NOT receive a monthly statement for the Budget Program.