Weld LP Gas Company

Application for Residential Service

Service Information

Delivery Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Propane Usage {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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(Check all that apply)
Primary Heat Source: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Secondary Heat Source: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is there a tank located at delivery address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If Yes, Do you Own or Lease? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If No, do you prefer to Purchase or Lease? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you own your home? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If no, you must complete the Landlord section of this form. Renters will start as Cash on Delivery.
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Landlord Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Payment Preference {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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How did you hear about Weld LP? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Applicant Information -

* - REQUIRED TO OPEN ACCOUNT
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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ex. name@address.com
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Mailing address is the same as service address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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(different than service address above)
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Employer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Co-Applicant Information

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Employer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Credit References

Ex. Utilities, previous landlord, etc. DO NOT LIST BANKS OR CREDIT CARDS
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Agreement

APPLICANTS MUST READ AND SIGN IN AGREEMENT WITH UNDERSTANDING OF THE COMPLETE TERMS AND CONDITIONS OF SALES AS DESCRIBED IN THE SECTION BELOW:

Terms:  Net Due 10th of each month unless other arrangements are made.  Past due service charge of 1.5% per month, or 18% annum, will be charged for accounts not paid on terms.  An account that becomes overdue may result in suspension of fuel deliveries or account may be placed on COD terms.  If it becomes necessary to place account with a collection agency or take legal action, the collection and/or legal fees will be added to the outstanding balance.

I/We hereby submit this application for an account with Weld LP Gas Company, Inc.  By submitting this application, I authorize Weld LP Gas Company, Inc. to make inquiries into the references supplied and/or any national credit reporting agency for pertinent financial information needed.

Signatures

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Terms and Conditions

(Revised 8/2015)

Installation Review:  We must perform an installation review in accordance with our policies and Colorado Statute prior to starting the delivery of propane to a new Customer.  We must be allowed entry as to check the entire system for leaks and all pilots be lit if applicable.  The cost of an installation review will generally be charged to you. In the event that we discover a leak or other unsatisfactory condition, you must have the identified problem corrected at your expense if you own the affected equipment. 

Delivery of Propane: We will deliver propane according to a route schedule that we establish.  We will use reasonable efforts to keep your propane supply adequate, but make no representation that we will inspect your supply on a regular schedule.  Weather conditions or a change in your circumstances can dramatically affect your usage.  Accordingly, you must inspect the amount of propane available from time to time.  If your supply is low or you run out of propane, we will give you priority service and we will not charge you an additional delivery fee or leak test fee in these circumstances.  If you request us to deliver propane to you at other times or on an emergency basis, we may, at our option, impose additional delivery charges.  You authorize us to make delivery of Propane whether or not you are present. IF YOU RUN OUT OF PROPANE FOR ANY REASON, WE WILL NOT BE RESPONSIBLE FOR ANY CONSEQUENTIAL DAMAGES YOU MAY INCUR, INCLUDING WITHOUT LIMITATION, FROZEN PIPES OR DAMAGE TO BUILDINGS OR LIVESTOCK.

  • If an off route or special delivery is requested, a charge will be made to your account.  If a delivery is made other than during regular scheduled business hours, Company will assess a special trip charge for said delivery. Charges as follows:  Normal Business Hours: $65.00 / After 6:00 p.m. and Weekends: $100.00.  Fees due at time of delivery.
  • Will Call/COD Customers: Please note that you should place your orders when your gauge reads 20%.  This will allow sufficient time to be placed on our delivery schedule before running out of fuel.  Customers placing orders with tank readings less than these guidelines may be charged an off route charge to guarantee delivery before running out of fuel.  If you have run out of fuel you are required to schedule a leak test so the system can be checked for leaks and pilots can be re-lit.  Charges as follows:  Normal Business Hours: $65.00 / After 6:00 p.m. and Weekends: $100.00.  Fees due at time of delivery.  As of June 30, 2004 customers are no longer accepted on a will call basis.
  • The propane tank on location must be owned by property owner or leased from Weld LP Gas Company.  It is illegal for any company to fill a propane tank owned by another company; full details of this requirement are stated in C.R.S. 8-20-301 – Unlawful Use of Container.  If the tank is owned by Weld LP Gas Company a Tank Lease Agreement must be signed prior to the first delivery.

Access to Property: You agree that our representatives may enter your Property (even if you are not present) for the purpose of making deliveries of Propane, for gaining access to equipment into which Propane is delivered, for repairs and maintenance, for installing or removing property belonging to us, for investigating the cause of any fire or accident, and for any other purpose related to the Service. We may refuse to provide Service if we believe that we cannot safely make delivery due to conditions on or approaching your Property, including unsafe road conditions, dangerous animals, or locked gates. You agree to maintain the Property in a condition so that the weight of our vehicle will not damage your driveway or yard, and agree not to hold us responsible for any such damage. You agree to provide ingress and egress to the equipment, i.e. gateway of 12 feet. You agree not to erect structures, fences, or other improvements and not to plant or grow trees or shrubs that restrict access to the equipment.  You agree to not to have any flammable material near the tank.

Purchase Price: We offer a daily price to our Customers based on their specific Customer information. These prices are set by us in our discretion and may vary due to a variety of factors, including without limitation: propane commodity prices and supply points, costs of transportation and storage, geographic location of the Customer in relation to our service units and supply points, volume usage, etc. You agree to pay our current daily price for propane unless you have a different agreement in place that determines the purchase price.  The daily price will be determined on the date of the delivery, or in the case of will-call customers the daily price will be determined on the date your delivery order is accepted.  All sales are final.  Company does not accept returns of fuel once delivered in good faith.

Payment Terms:  All bills shall become due upon presentation and shall be payable to Weld LP Gas Company at P.O. Box 365, Platteville, CO 80651.  In the event on non-payment of bills when due, Customer shall pay in addition Company’s past due service charge of 1.5% per month or 18% annum.  Company may also at any time require Customer to pre-buy or pay on delivery.

  • If an amount is outstanding after thirty days, NO DELIVERIES CAN BE MADE TO CUSTOMER.  You could be placing yourself in jeopardy of running out of fuel. 
  • Any account set up on our budget plan, that is not current on their budget payments, will not receive any future deliveries until these payments are made current.
  • We reserve the right to contact your landlord in cases of past due balances of 30 days or more.
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Weld LP Gas Company

Weld LP Gas Company

Application for Residential Service

Service Information

Delivery Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Propane Usage {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Primary Heat Source: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Secondary Heat Source: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is there a tank located at delivery address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If Yes, Do you Own or Lease? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Tank Size {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Level % {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Current Supplier: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If No, do you prefer to Purchase or Lease? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you own your home? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Landlord Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Landlord Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Payment Preference {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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How did you hear about Weld LP? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Applicant Information -

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Maiden Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Monthly Mortgage/Rent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Gross Monthly Income from all sources {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mailing address is the same as service address? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Previous Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Employer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Employer Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Co-Applicant Information

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Maiden Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Credit References

Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Agreement

APPLICANTS MUST READ AND SIGN IN AGREEMENT WITH UNDERSTANDING OF THE COMPLETE TERMS AND CONDITIONS OF SALES AS DESCRIBED IN THE SECTION BELOW:

Terms:  Net Due 10th of each month unless other arrangements are made.  Past due service charge of 1.5% per month, or 18% annum, will be charged for accounts not paid on terms.  An account that becomes overdue may result in suspension of fuel deliveries or account may be placed on COD terms.  If it becomes necessary to place account with a collection agency or take legal action, the collection and/or legal fees will be added to the outstanding balance.

I/We hereby submit this application for an account with Weld LP Gas Company, Inc.  By submitting this application, I authorize Weld LP Gas Company, Inc. to make inquiries into the references supplied and/or any national credit reporting agency for pertinent financial information needed.

Signatures

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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I understand that by checking this box and typing my name and date and checking, I am agreeing to the terms of this agreement and the truthfulness of the information I have submitted to the best of my knowledge. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Terms and Conditions

Installation Review:  We must perform an installation review in accordance with our policies and Colorado Statute prior to starting the delivery of propane to a new Customer.  We must be allowed entry as to check the entire system for leaks and all pilots be lit if applicable.  The cost of an installation review will generally be charged to you. In the event that we discover a leak or other unsatisfactory condition, you must have the identified problem corrected at your expense if you own the affected equipment. 

Delivery of Propane: We will deliver propane according to a route schedule that we establish.  We will use reasonable efforts to keep your propane supply adequate, but make no representation that we will inspect your supply on a regular schedule.  Weather conditions or a change in your circumstances can dramatically affect your usage.  Accordingly, you must inspect the amount of propane available from time to time.  If your supply is low or you run out of propane, we will give you priority service and we will not charge you an additional delivery fee or leak test fee in these circumstances.  If you request us to deliver propane to you at other times or on an emergency basis, we may, at our option, impose additional delivery charges.  You authorize us to make delivery of Propane whether or not you are present. IF YOU RUN OUT OF PROPANE FOR ANY REASON, WE WILL NOT BE RESPONSIBLE FOR ANY CONSEQUENTIAL DAMAGES YOU MAY INCUR, INCLUDING WITHOUT LIMITATION, FROZEN PIPES OR DAMAGE TO BUILDINGS OR LIVESTOCK.

  • If an off route or special delivery is requested, a charge will be made to your account.  If a delivery is made other than during regular scheduled business hours, Company will assess a special trip charge for said delivery. Charges as follows:  Normal Business Hours: $65.00 / After 6:00 p.m. and Weekends: $100.00.  Fees due at time of delivery.
  • Will Call/COD Customers: Please note that you should place your orders when your gauge reads 20%.  This will allow sufficient time to be placed on our delivery schedule before running out of fuel.  Customers placing orders with tank readings less than these guidelines may be charged an off route charge to guarantee delivery before running out of fuel.  If you have run out of fuel you are required to schedule a leak test so the system can be checked for leaks and pilots can be re-lit.  Charges as follows:  Normal Business Hours: $65.00 / After 6:00 p.m. and Weekends: $100.00.  Fees due at time of delivery.  As of June 30, 2004 customers are no longer accepted on a will call basis.
  • The propane tank on location must be owned by property owner or leased from Weld LP Gas Company.  It is illegal for any company to fill a propane tank owned by another company; full details of this requirement are stated in C.R.S. 8-20-301 – Unlawful Use of Container.  If the tank is owned by Weld LP Gas Company a Tank Lease Agreement must be signed prior to the first delivery.

Access to Property: You agree that our representatives may enter your Property (even if you are not present) for the purpose of making deliveries of Propane, for gaining access to equipment into which Propane is delivered, for repairs and maintenance, for installing or removing property belonging to us, for investigating the cause of any fire or accident, and for any other purpose related to the Service. We may refuse to provide Service if we believe that we cannot safely make delivery due to conditions on or approaching your Property, including unsafe road conditions, dangerous animals, or locked gates. You agree to maintain the Property in a condition so that the weight of our vehicle will not damage your driveway or yard, and agree not to hold us responsible for any such damage. You agree to provide ingress and egress to the equipment, i.e. gateway of 12 feet. You agree not to erect structures, fences, or other improvements and not to plant or grow trees or shrubs that restrict access to the equipment.  You agree to not to have any flammable material near the tank.

Purchase Price: We offer a daily price to our Customers based on their specific Customer information. These prices are set by us in our discretion and may vary due to a variety of factors, including without limitation: propane commodity prices and supply points, costs of transportation and storage, geographic location of the Customer in relation to our service units and supply points, volume usage, etc. You agree to pay our current daily price for propane unless you have a different agreement in place that determines the purchase price.  The daily price will be determined on the date of the delivery, or in the case of will-call customers the daily price will be determined on the date your delivery order is accepted.  All sales are final.  Company does not accept returns of fuel once delivered in good faith.

Payment Terms:  All bills shall become due upon presentation and shall be payable to Weld LP Gas Company at P.O. Box 365, Platteville, CO 80651.  In the event on non-payment of bills when due, Customer shall pay in addition Company’s past due service charge of 1.5% per month or 18% annum.  Company may also at any time require Customer to pre-buy or pay on delivery.

  • If an amount is outstanding after thirty days, NO DELIVERIES CAN BE MADE TO CUSTOMER.  You could be placing yourself in jeopardy of running out of fuel. 
  • Any account set up on our budget plan, that is not current on their budget payments, will not receive any future deliveries until these payments are made current.
  • We reserve the right to contact your landlord in cases of past due balances of 30 days or more.
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