Serving New York's Finger Lakes
Region Since 1939
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Application for Open Account and Service Agreement
CLICK HERE TO DOWNLOAD THIS APPLICATION FORM IN PDF FORMAT.
Please Fill Out The Following Form
were dealing with a particular
Phelps Sungas representative, please
(First, Initial, Last):
to receive my Invoice / Statement by
Landlord's Phone Number:
Propane Service to be Provided at
the following location:
Current Propane Supplier:
Propane will be used for
Third Party Notification:
Third party notification is
available (see section F, below).
I would like additional information
on third party notification.
This agreement supersedes any
previously existing agreement
between customer and Sungas.
not sign this Agreement before you
read it or if it contains any blank
Fees and Finance Charges are subject
to change. A current Fee
Schedule is available upon request.
agree to be subject to the terms
disclosed in the credit or purchase
agreement when issued and any
purchases will constitute my/our
acceptance of those terms. We
hereby certify that the information
provided above and any attachments
included herein are true and correct
and are furnished for the purpose of
inducing Sungas to extend credit to
the undersigned. Applicant(s)
authorizes Sungas to obtain a credit
report in connection with this
application and any update renewal,
modification, collection or
extension of the credit and
authorizes Sungas to report my/our
performance under this agreement or
any other agreement I/we may have
entered into with Sungas to any
credit reporting agency and to
answer any questions regarding
my/our credit history with Sungas.
Upon request, Sungas will inform
Applicant of the name and address of
any credit reporting agency which
furnished a report.
type your name in the space below
and fill in the date.
(Type your name into full
in the field above).
I understand and agree
my name into the field
above is the same as
providing my handwritten
signature to this
application, and has the
same legal force and
effect as if I had
signed this document
personally before and in the
presence of a Phelps Sungas representative.
In consideration of
Phelps Sungas, Inc.,
Sungas, selling goods
and services to me on
Open Account, I
have read and hereby agree to the
terms and conditions set
A. Sungas bills will be paid within
20 days of the invoice date to avoid
a FINANCE CHARGE.
B. If I do not pay my Open Account
total due within the time specified
FINANCE CHARGE (Time
Price Differential) may be computed
on the unpaid Average Daily Balance.
I will pay a
determined by multiplying the
Average Daily Balance by the
appropriate periodic rate of 1.5%
per month (ANNUAL PERCENTAGE RATE
18.0%) Buyer agrees to pay a
minimum FINANCE CHARGE of
$4.00 per month.
SHUTOFF of my gas supply
SPECIAL TRIP CHARGE will
be made for run outs or turning my
gas service back on.
may be required.
C. I understand that the tanks,
regulators, blocks and other special
equipment installed by Sungas for my
use is the property of Sungas and
TITLE TO THAT EQUIPMENT remains
with Sungas. While I am using this
equipment I agree that:
1. I will not tamper with or move
2. I will not allow anyone else to
service, put gas in or use this
3. I will notify Sungas when any
appliances connected to this service
are added, removed or replaced.
4. Sungas has reasonable access to
it’s equipment for service,
maintenance or removal.
D. I understand that it is the
policy of Sungas to have all
customers on automatic fill and
Sungas will make every attempt to
maintain a dependable supply of
propane, however Sungas makes no
warranties, nor assumes any
liability for consequences if the
system runs out of propane.
1. I agree to maintain access to the
propane tanks in such a manner as to
avoid undue risk, damage or injury
to Sungas employees and equipment.
Driveways and areas around the
tank must be clear of snow and
obstacles for us to make a delivery.
2. I understand that if an
Route delivery is made because I
have not met the terms and
conditions of this agreement, I will
Special Trip Charge as
per the Fee Schedule in effect at
the time of the
3. I acknowledge that vehicles used
for the purpose of delivering my
bulk propane can weigh as much as
33,000# and are 8 feet in width. I
agree to maintain a suitable means
of egress and that Sungas will not
be liable for damage to my driveway.
4. I understand that Will Call
service is available upon request
and upon completion of a written
Will Call Request form. A price
variance of $.20 per gallon will be
charged for Will Call customers.
5. I understand that if the premises
to be served by Sungas is a seasonal
dwelling or not continuously
occupied, I must notify Sungas and
agree to the terms of a Sungas
addendum to this agreement.
E. I further agree that if I do not
abide by the terms and conditions of
this agreement I;
1. Waive any claim for loss, damage
or injury which may result.
2. Will pay reasonable legal fees
and collection cost incurred by
Sungas to retrieve it’s property or
collect overdue payments.
F. I understand that Sungas provides
third party notification in the
event that my fuel supply should be
cutoff for non-payment of my bill as
well as other services such as
budget billing, installment billing
and price cap programs. If I choose
to participate in any of these
programs, I agree to abide by the
terms and conditions of these
programs as provided to me upon my
Returns and Refunds: Upon
termination of service covered by
this agreement, Sungas will credit
any gas remaining in the propane
system at the price for which it was
paid less an
ACCOUNT HANDLING FEE
of 10 cents per gallon. If the
propane tank and propane is removed
from the property by Sungas, then a
PUMP OUT FEE of $20.00 per
DOT cylinder(s) and $75.00 per AMSE
tank(s) will be deducted from the
price of gas being returned for
credit. There is no fee charged to
remove an empty propane system from
TERM: Service is
terminable at will by either Sungas
or customer. Termination shall occur
when Sungas removes its equipment
from your premises and all balances
owing are paid.
If you experience any difficulties using
this form, please contact us via email at
Phelps Sungas, Inc.
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PHELPS SUNGAS, INC.
224 Cross Road
Geneva, New York 14456
(315) 789-7107 fax
IN CASE OF EMERGENCY,
To report a propane gas leak, carbon monoxide alarm or other emergency,
please also call our toll-free 24-hour number:
For your convenience you may print out this form and fax it to us at (315)
BBQ Cylinder Exchange
224 Cross Road
Geneva, New York 14456
Phone: (315) 789-3285
Toll Free: (800) 458-1085
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