Mission
Alone We are Strong, Together We are Stronger....
Join the Group - Experience the Difference

CURRENT BRAND LABEL
 

________________________________________

Total Tanks: ______  Gasoline:_____   Diesel:_______

Total Capacity: (Gas)___________  (Diesel) ________

CURRENT FUEL SUPPLIER

Company Name: _____________________________

Contact Person Name: ___________________________

Address: _____________________________________

City, State: ________________Zip ________________

Email: _____________________Website: _____________________

GAS COMPANY CREDIT CARD PROGRAM (if any) 

Company Name: ______________________________________

Contact Person Name: ______________________________________

Address: ________________________________________________

City, State: _______________Zip ________________

Email: _____________________Website: _____________________

PER MONTH AVERAGE SALES

Grocery:___________ Gallons (Gas): _________ (Diesel): ________

Lottery Commission Per Month: ____________________________

SECURITY DEPOSIT WITH FUEL SUPPLIER

YES: ______________  NO: ________________

(IF YES) – HOW MUCH: $_________________

Address

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