Please be advised that Rock Mountain Energy Ltd. sends all customer invoices and statements via email, therefore email addresses are required.
Customers who do not have an email address may contact the office to arrange mail delivery.
Trade references from whom customer is buying on credit - Name and fax number Note: Credit Cards are not considered as trade references
Est. Month Usage (Litres)
Check those that apply:
Cardlock #Card RequiredDelivered FuelColoured Fuel
Estimated highest 1 month purchases: $ Credit limit requested: $ Additional Information or Notes
Accounts are due in full on or before the 20th of the following month. If payment is not received on or prior to this date, penalty interest will be applied on all invoices over 30 days old, from date of invoice, at a rate of 2% per month (26.8% per annum). Rock Mountain reserves the right to suspend or alter credit terms as required.
The individual(s) electronically submitting this application for credit on behalf of the applicant proprietorship, partnership, or corporation noted above, if applicable, hereby individually in their individual capacities, personally, and unconditionally guarantee payment to Rock Mountain Energy Ltd. for all amounts now or hereafter owing by the above applicant for goods delivered, services rendered, and all interest accrued on any amounts past due.