No. 0692345 - Wehof Forms
No.
345
0692
“Committed to Quality & Service”
We are humble and grateful that so many Fuel Oil,
Propane and Home Comfort companies have come to rely
on our Products and Services. Along the way, we would like to
think that we have learned from this changing industry, that
we have contributed to it’s evolution and helped companies
and their staff cope with the ever changing technology and
governmental requirements which confront them day in and
day out, that’s what we do to continuously service our clients
with the most up to date information and products.
We understand that our product group is an overhead
item for your enterprise, that’s why we try to not only be
competitive but deliver value with every order.  With that said,
some companies like to advertise all the free service they
provide…… Really? Nothing in life is free…. one way or
another, all the costs are in the total bottom line. Whenever
asked, we will gladly supply a delivered cost of our product to
your loading dock or office. With all the facts, you can make
the call on how much value you get from your vendor!
We are your Value Added Vendor !!
Sincerely,
Walter S. Wehof
President, WEHOF FORMS
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
“Committed to the Energy Industry”
DEALERS’ ASSOCIATION
ARKET
ER
NEW YO
R
ND
MM
EU
S
PE
ENT TROL
INDEPENDENT CONNECTICUT PETROLEUM ASSOCIATION
TATE INDEPE
KS
N EW J ERSEY
P ROPANE G AS A SSOCIATION
Western
Propane Gas
Association
Hudson Valley
Oil Heat Council
Vermont Fuel Dealers Association
We no t only support you…
we support your indus t r y!
FormsPro
A Symbol Of Excellence
The FormsPro Stor y
Created in 2002, the FormsPro visually represents the high level of
service that our staff has been providing since 1982, which has been
the key ingredient in our success story. With steady yearly growth
in sales and customers served, we thank our current customers, and
offer this great service to those that may not be familiar with us.
The FormsPro is:
• A Sales Team with a combined printing experience
•
•
•
•
•
•
level of over 100 years.
A Graphics Team with a combined art composition
experience level of over 50 years.
A Staff that knows all the printed products that Energy
Companies need to operate.
A Staff with vast knowledge of the software systems
available to the Energy Industry.
A Staff that is fully networked with equipment and meter
installation specialists.
A Staff that moves at the speed of business.
A Staff that has one of the largest stock forms inventories to
service accounts better.
The FormsPro utilizes all its expertise together to:
• Analyze your needs;
• Adhere to your software specifications and equipment
requirements;
• Provide you with the best forms that will keep your
company operating at peak efficiency.
Our FormsPro Te am is committed to servicing your industry.
42 Readington Road • Somerville, NJ 08876
Toll Free 800-221-1209 • Local Phone 908-722-1001
Fax 908-722-8585 • Email: [email protected]
www.FormsPro.net
TABLE OF CONTENTS
CUSTOM PRODUCTS
CUSTOM BUSINESS FORMS
Oil Forms Propane Forms
DOORKNOB HANGERS
Doorknob Hangers
Doorknob Slip Tickets
Payment Envelopes
6-7
8-9
12
12
11
SUPPLIES
Calendars
Computer Paper
Fill Pipe Tags
Gloves
19
18
17
16
Poly Bags - Custom & Generic 10
STATIONARY
Checks
13
Envelopes
15
Post Cards
14
Stationary - Letterhead, Business
Cards, Envelopes, & Folders 14
Labels
17-18
Register Forms
18
Promotional Product - Magnets 20-21
“GiveAways”
ELECTRONIC METER TICKETS
Custom Electronic Tickets
F-RAMS Tickets
Liquid Control Tickets
22
23
26-27
Mid:Com Tickets
Neptune Tickets
Total Control Systems
28-29
30
24-25
PROPANE MARKETPLACE
SOFTWARE COMPATIBLE FORMS
Advanced Digital Data Forms 50-51
Automated Wireless/Petrodata 52-53
Cargas 34
DeYoung
33
Rural Computer Consultants 31
Suburban Software
32
Thermal Roll Tickets
37
USEFUL PROPANE FORMS
Propane Delivery Reports Gas Warning Labels
“Not At Home” Tags
Out of Gas/Leak Check Form
Propane Tank Labels
TouchStar Thermal Roll Tickets
Vertrax Thermal Roll Tickets
36
35
35
36
35
37
33
OIL MARKETPLACE
SOFTWARE COMPATIBLE FORMS
Advanced Digital Data Forms 50-51
Automated Wireless/Petrodata 52-53
Blue Cow Software
54-55
CNC Custom/Software Forms
42-43
Digital Dispatcher 38-39
DRM Custom/Software Forms 40-41
Fuel Data Systems
57
Market Line
44-45
Micro Analyst Forms
46-47
Raven Tickets
51
RDS/WinFUEL/Quick Oil Terra Vista
56
Thermal Roll Tickets
37-38
United Data Systems
48-49
USEFUL OIL DELIVERY PRODUCTS
Custom Boiler & Furnace Tags 58
Emergency Spill Kit
60
Fuel Delivery Reports
59
Sorbent Products
61
Fuel/Delivery Order Pads 59
HVAC MARKETPLACE
Custom Work Orders
Gas Check Form
HVAC Work Order
63
32
62
Plumbing Work Order
Portable Office - Aluminum
Forms Holder
POOL/SPA MARKETPLACE
Appliance Work Order
Pool Work Order
63
63
Pool/Spa Doorknob Hanger
62
62
63
6
CUSTOM PRODUCTS - OIL FORMS
METER TICKETS
REORDER FROM WEHOF FORMS (800) 221-1209
VALLEY OIL ACCEPTS:
VALLEY OIL ACCEPTS:
IF YOU WISH TO PAY BY CREDIT CARD, FILL OUT THE
INFORMATION ON THE DETACHABLE STUB ON PLY 2 OF THIS TICKET.
We appreciate your business!!
IF YOU WISH TO PAY BY CREDIT CARD, FILL OUT THE
INFORMATION ON THE DETACHABLE STUB ON PLY 2 OF THIS TICKET.
We appreciate your business!!
VALLEY OIL ACCEPTS:
IF YOU WISH TO PAY BY CREDIT CARD, FILL OUT THE
INFORMATION ON THE DETACHABLE STUB ON PLY 2 DELIVERY
OF THIS TICKET.
DELIVERY
ADDRESS
ADDRESS
We appreciate your business!!
FUEL
• Heating Oil
• Kerosene
• Gasoline
• Diesel
• Farm
• On Road
• Off Road
FUEL
• Heating Oil
• Kerosene
• Gasoline
• Diesel
• Farm
• On Road
• Off Road
DELIVERY
ADDRESS
FUEL
• Heating Oil
• Kerosene
• Gasoline
• Diesel
• Farm
• On Road
• Off Road
SERVICES
• Automatic
Delivery
• Budget Plan
• Heating
24/7 Service
• Tune-ups
• Service Plans
• Air Conditioning
SALES
• Furnaces
• Boilers
• Water Heaters
• Air Conditioning
• Indoor Air
Quality
• Financing
SALES
• Furnaces
• Boilers
• Water Heaters
• Air Conditioning
• Indoor Air
Quality
• Financing
SALES
• Furnaces
Boilers
PAY THIS AMOUNT•• Water
Heaters
THIS no
AMOUNT
• Air Conditioning
Please pay fromPAY
this invoice,
other invoice
will be sent.
• Indoor
Budget and Auto pay customers DO
NOT Air
PAY.
Quality
(For your records only.)• Financing
Partial
Fill вќ’
в–І в–І в–І
в–І
в–І
VALLEY OIL. IS RESPONSIBLE FOR THE DELIVERY OF PRODUCT TO THE RECEIVING PIPE OR OUTLET
DESIGNATED BY CUSTOMER. CUSTOMER AGREES THAT NEITHER VALLEY OIL, NOR ITS EMPLOYEES OR
AGENTS, ARE OR SHALL BE LIABLE UNDER ANY CIRCUMSTANCES FOR ANY DAMAGES RESULTING FROM
LEAKS OR FOR THE FAILURE OF THE RECEIVING TANK OR ASSOCIATED PIPING OR ANY OTHER MATTER.
вќ’
в–І в–І в–І
в–І
PAY THIS AMOUNT
THIS AMOUNT
в–Іbe sent.
Please pay fromPAY
this invoice,
no other invoice will
Budget and Auto pay customers DO NOT PAY.
(For your records only.)
PAY THIS AMOUNT в–І в–І в–І
Partial
Cash
вќ’ Payment Received
THIS no
AMOUNT
в–Іbe sent. в–І
Please pay fromPAY
this invoice,
other invoice will
Charge вќ’
Fill вќ’
Budget and Auto pay customers DO NOT PAY.
вќ’ Payment Received
вќ’
Cash
Charge
W
SERVICES
• Automatic
Delivery
• Budget Plan
• Heating
24/7 Service
• Tune-ups
• Service Plans
• Air Conditioning
SERVICES
• Automatic
Delivery
• Budget Plan
• Heating
24/7 Service
• Tune-ups
• Service Plans
• Air Conditioning
Partial
вќ’
VALLEY OIL. IS RESPONSIBLE FOR THE DELIVERY OF PRODUCT TO THE RECEIVING PIPE OR OUTLET
DESIGNATED BY CUSTOMER. CUSTOMER AGREES THAT NEITHER VALLEY OIL, NOR ITS EMPLOYEES OR
AGENTS, ARE OR SHALL BE LIABLE UNDER ANY CIRCUMSTANCES FOR ANY DAMAGES RESULTING FROM
LEAKS OR FOR THE FAILURE OF THE RECEIVING TANK OR ASSOCIATED PIPING OR ANY OTHER MATTER.
(For your records only.)
Cash
Charge
# 2 HEATING OIL - DYED. NON-TAXABLE USE ONLY. PENALTY FOR
Fill
TAXABLE USE.
вќ’ Payment Received
вќ’
вќ’
# 2 HEATING OIL - DYED. NON-TAXABLE USE ONLY. PENALTY FOR
TAXABLE USE.
вќ’
OIL. IS RESPONSIBLE FOR THE DELIVERY OF PRODUCT TO THE RECEIVING PIPE OR OUTLET
# 2 HEATING OIL - DYED. PRODUCT IS SOLD FOR OFFVALLEY
ROAD
USE ONLY.
вќ’ # 2 HEATING OIL - DYED. PRODUCT IS SOLD FOR OFF ROAD USE ONLY.
DESIGNATED BY CUSTOMER. CUSTOMER AGREES THAT NEITHER VALLEY OIL, NOR ITS EMPLOYEES OR
AGENTS, ARE OR SHALL BE LIABLE UNDER ANY CIRCUMSTANCES FOR ANY DAMAGES
RESULTING
NOT LEGAL FOR MOTOR VEHICLE USE.
NOT
LEGAL FROM
FOR MOTOR VEHICLE USE.
вќ’
вќ’FOR
DIESEL FUEL - L/S DYED. NON-TAXABLE USE ONLY. PENALTY
FOR
DIESEL FUEL - L/S DYED. NON-TAXABLE USE ONLY. PENALTY FOR
вќ’ # 2 HEATING
OIL - DYED. NON-TAXABLE USE ONLY. PENALTY
TAXABLE USE.
TAXABLE USE.
TAXABLE USE.
вќ’
вќ’
вќ’
LEAKS OR FOR THE FAILURE OF THE RECEIVING TANK OR ASSOCIATED PIPING OR ANY OTHER MATTER.
DIESEL FUEL - L/S CLEAR. SUITABLE FOR ON ROAD/HIGHWAY
USE. OIL - DYED. PRODUCT IS SOLD FOR OFF ROAD
вќ’USE
DIESEL
FUEL - L/S CLEAR. SUITABLE FOR ON ROAD/HIGHWAY USE.
вќ’ # 2 HEATING
ONLY.
FOR MOTOR VEHICLE.
FOR MOTOR VEHICLE.
NOT LEGAL FOR MOTOR VEHICLE USE.
DIESEL FUEL - ULTRA L/S DYED. NON-TAXABLE USE ONLY.
PENALTY
вќ’ FOR
DIESEL FUEL - ULTRA L/S DYED. NON-TAXABLE USE ONLY. PENALTY FOR
вќ’ DIESEL
FUELFOR
- L/S DYED. NON-TAXABLE USE ONLY. PENALTY
TAXABLE USE.
TAXABLE USE.
TAXABLE USE.
DIESEL FUEL - ULTRA L/S CLEAR. SUITABLE FOR ON-ROAD/HIGHWAY
вќ’ DIESEL
вќ’ DIESEL FUEL -USE.
L/S CLEAR. SUITABLE FOR ON ROAD/HIGHWAY
USE. FUEL - ULTRA L/S CLEAR. SUITABLE FOR ON-ROAD/HIGHWAY USE.
FOR MOTOR VEHICLE.
FOR MOTOR VEHICLE.
FOR MOTOR VEHICLE.
вќ’
DIESEL FUEL - ULTRA L/S DYED. NON-TAXABLE USE ONLY. PENALTY FOR
TAXABLE USE.
54 Somerset Street
вќ’ DIESEL FUEL - ULTRA L/S CLEAR. SUITABLE FOR ON-ROAD/HIGHWAY USE.
VEHICLE.
Hopewell,FOR
NJMOTOR
08525
(609) 466-0015
IF PAYING BY CREDIT CARD, PLEASE CHECK THE CARD USED,
N.J. H.I.C. #COMPLETELY
13VH00943400
FILL OUT THIS CREDIT CARD PAYMENT AUTHORIZATION
54 Somerset Street
Hopewell, NJ 08525
(609) 466-0015
N.J. H.I.C. # 13VH00943400
STUB, AND REMIT TO VALLEY OIL, SOMERSET ST., HOPEWELL, NJ 08525.
“Serving you since VALLEY
1970” OIL ACCEPTS:
“Serving you since 1970”
вќ’
вќ’
CARD NO.
06401
EXP. DATE
OFFICE COPY
AMOUNT
SIGNATURE
06401
$
CUSTOMER COPY
06401
REMITTANCE COPY & STUB FOR CREDIT CARD PAYMENTS
D
E
L
T
O
ACCOUNT NUMBER
TICKET NO.
ZONE
в—Џ
FILL
SIZE
TYPE
PRO
DDD
KFA
DESCRIPTION
CUST. TEL. NO.
P P GALLONS
HWG
LAST DEL. DATE
RODD
GLD
TANK
NOT
FULL
в–І
I
N
S
T
R
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
X
B
I
L
L
BY
P.O. Box 461
Wappingers Falls, NY 12590
(845) 297-6089
T
O
в—Џ
в—Џ
Wappingers Falls Office
P.O. Box 48
Rhinebeck, NY 12572
(845) 876-2033
CUSTOMER
COPY
YOUR LOCAL KOSCO OFFICE
в—Џ
Rhinebeck Office
PLEASE PAY FROM THIS INVOICE WITHIN 30 DAYS
THIS IS THE ONLY INVOICE YOU WILL RECEIVE – DETACH
AND RETAIN THIS COPY – USE E-Z MAIL ENVELOPE.
в—Џ
Catskill/Hudson Office
P.O. Box 351
Catskill, NY 12414
(518) 943-3500 • (518) 828-9448
$
в—Џ
в–І
www.koscocomfort.com
Corporate Office
P.O. Box 760
Port Ewen, NY 12466
(845) 331-0770
RECEIVED
PAYMENT
REORDER FROM WEHOF FORMS 1(800) 221-1209
в—Џ
IF YOU HAVE ANY QUESTIONS ABOUT YOUR BILL, SEND INQUIRES TO:
в—Џ
IMPORTANT NOTICE CONCERNING THE FEDERAL TRUTH-IN-LENDING ACT ON BACK.
REMITTANCE
COPY
CUSTOMER SIGNATURE
OFFICE
COPY
REORDER FROM WEHOF FORMS (800) 221-1209
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
P.O. BOX 465 • FEDERALSBURG, MD 21632
Tel: (410) 754-8184 • (800) 638-7802 • Fax: (410) 754-9158
www.trigas-oil.com
REORDER FROM WEHOF FORMS 1(800) 221-1209
BILL TO
ADDRESS
DELIVERY
ADDRESS
OVER 115 YEARS OF SERVICE
www.cksmithco.com
(508) 753-1475
FREE ON-LINE
PAYMENT
www.trigas-oil.com
CLICK ON
Pay My Bill
• Heating Fuels
• Propane
Delivery &
Service
• Gasoline
INVOICE
• Heating & Air
Conditioning
Systems
• Plumbing
DESCRIPTION OF CHARGE
• Air Filtration
Systems
AMOUNT
F
irst, you will receive a highly
competitive price. Next, you will
have your forms composed on stateof-the-art graphics equipment at no
charge. Finally, we will manufacture
your form on the highest quality
papers to assure proper performance.
W
CHECK
CHARGE
PARTIAL
FILL
DYED FUEL OIL;
NON TAXABLE
USE ONLY;
PENALTY FOR
TAXABLE USE.
Please pay from
this invoice; no
other invoice will
be provided.
PAY THIS AMOUNT
CUSTOMER
SIGNATURE
в–І
в–І
вњ—
01001
PETROLEUM
SEE BACK OF TICKET FOR PRODUCT INFORMATION.
FOR YOUR CONVENIENCE, TRI GAS & OIL ACCEPTS PAYMENT
BY CREDIT CARD. IF YOU WISH TO PAY BY CREDIT CARD,
FILL OUT THE INFORMATION ON THE FLAP ON THE E-Z ENVELOPE.
Budget Customer
payments due by
the 15th of each
month.
r NOT FULL
CASH
PAYMENTS NOT RECEIVED BEFORE DUE DATE WILL BE ASSESSED
A FINANCE CHARGE OF 1.5% PER MONTH.
A finance charge
computed at the
periodic rate of
1.5% per month
($1.00 Minimum)
will be added to
balances 30 days
past due from
date of invoice.
This is an annual
percentage rate
of 18%.
WE ACCEPT:
PLEASE PAY THIS AMOUNT вћЎ
We sell Propane & Heating Fuels
IMPORTANT SAFETY INFORMATION, AND CONDITIONS ON BACK
CHECK
$
F
rom meter tickets to magnets,
invoices to envelopes or anything in
between, we can duplicate or improve
your present custom forms. Our
knowledge of the industry helps us
deliver the appropriate form for the
task at hand. Send us a sample and let
us do the rest.
ACCOUNT
STATUS:
вќ’
вќ’
вќ’
вќ’
вќ’
• Diesel Fuels
REC'D
PAYMENT
ehof Forms specializes in
producing high quality custom printed
business forms.
ehof Forms has been growing on a reputation of high quality
and personalized service. We look
forward to putting this reputation to
work for you.
99 CRESCENT STREET • WORCESTER, MA 01605
BILL TO
ADDRESS
DELIVERY
ADDRESS
• WE Quote
• WE Design
• WE Improve
• WE Compose
• WE Deliver On Time!
r
THIS IS YOUR INVOICE
CUSTOMER COPY
CASH
r
OFFICE COPY
REV. 8606BA
* Excessive typesetting or logo design may
incur a composition charge.
TO ORDER CALL
800-221-1209
CUSTOM PRODUCTS - OIL FORMS
INVOICES
I
P.O. BOX 10
2 THOMPSON STREET
RARITAN, N.J. 08869
(908) 707-1776
(888) 782-3001
FAX: (908) 707-4158
n addition to producing the different
types of forms listed below, we are
experts at providing answers when you
need it most. We can help troubleshoot
equipment problems, recommend new
equipment or systems, and improve
current forms and processes.
P.O. BOX 1071 A
673 NEW BRUNSWICK AVENUE
RAHWAY, NJ 07065
(732) 388-1000
(732) 499-8555
FAX: (732) 382-3453
ACCOUNT NO.
DATE:
DATE
REF #
LOC #
QUANTITY
DESCRIPTION
PRICE
AMOUNT
INVOICE TOTAL:
Our contacts and knowledge of the
industry, coupled with our experience,
are a value added premium you get with
every order at no extra charge. So don’t
fall for the gimmicks of low ball prices and
poor quality when you can have the best.
PREVIOUS BALANCE ON ACCOUNT:
1.5% Finance Charge Per Month On Accounts Past 30 Days
TOTAL AMOUNT DUE:
Please tear along perforated line and return bottom portion. Thank You!!
INVOICE TOTAL:
PREVIOUS BALANCE ON ACCOUNT:
TOTAL AMOUNT DUE:
PAYMENT AMOUNT
SKYLANDS ENERGY SERVICE INC.
CONTRACTS / PROPOSALS
OIL BURNER MAINTENANCE
AND
CUSTOMER SERVICES
SERVICE AGREEMENT
•
FUELOIL
FUELOIL
24HOURBURNERSERVICE
EXPERIENCEDSERVICEENGINEERS
COMPLETEHEATINGINSTALLATIONS
DOMESTICWATERINSTALLATIONS
BOILERANDHOTAIRFURNACESINSTALLED
AIRCONDITIONING
PLUMBING
CommitmenttoService
Cain Oil has been servicing customers for over 30 years.
During this time we have learned a lot about what it takes
to be a successful fuel oil provider. We know the value you
place on service and quality so
we deliver more than oil. We
offer you the peace of mind that
your family’s comfort and security is our top priority. Our staff
•
•
•
•
•
•
•
• Meter Tickets
• Invoices
• Statements
• Checks
• Mailers
• Budget Forms
• Envelopes
• Letterheads
• Contracts & Proposals
• Brochures & Advertisements
CommitmenttoService
Cain Oil has been servicing customers for over 30 years.
During this time we have learned a lot about what it takes
18 GOULD STREET
to be a successful fuel oil provider. We know the value you
READING, MAplace
01867
on service and quality so
we deliver more than oil. We
offer you the peace of mind that
your family’s comfort and security is our top priority. Our staff
is professionally trained
and certified and we offer
unmatched customer service.
TEL.
SELECTTHEOILBURNERMAINTENANCEAND
SERVICEAGREEMENTPLANTHATSUITSYOUBEST.
Cain Oil Inc.
QTY.
CO2
962 Southampton Road
Westfield, MA 01085
tel: (413) 562-0650
fax: (413) 562-0657
www.FuelServices.biz
CLEAN COIL & CHECK FIN CONDITION
ENT
ЛљF
LVG
ЛљF
OIL LEVEL & CONDITION
ЛљF
ЛљF
CONDENSATE AREAS
INSPECT & CLEAN DRAIN PAN
INSPECT & CLEAN DRAIN
AIR FILTERS
REPLACED
HEATING - GAS
BURNER & HEAT EXCHANGER
FUEL SUPPLY & PRESSURE
PILOT ASSEMBLY
FLAME ADJUSTMENT
PRIMARY RELAY & FLUE
FAN & LIMIT SWITCH OPERATION
BLOWER ASSEMBLY
RV VALVE
STRIP HEAT
DEFROST CYCLE
ELECTRICAL COMPONENTS
CONTACTORS
PRESS. SWITCH
REPLACE
HEATING - OIL
CLEANED BURNER
CLEANED UNIT
CLEANED CHIMNEY BASE
CLEANED SMOKE PIPE
CHECKED CONTROLS
OILED MOTORS
OILED CIRCULATOR
OILED BLOWER
REPAIRED OIL LEAKS
CHECKED DRAFT
ADJUSTED FLAME
REPLACED NOZZLE
REPLACED FILTER
REPLACED STRAINER
EFFICIENCY TEST
CHECKED TRANSFORMER
CHECKED OPERATION
CHECKED PRESSURE
ANTIFREEZE
MAKE
CO READING
FUEL PUMP
PSI
CUT OFF
PSI
VACUUM
IN HG
PROBLEM
REPORTED:
STATE
MODEL
/
TEL.
Cain Oil Inc.
18 GOULD STREET
READING, MA 01867
PLAN4
PLAN3
PLAN2
EMAIL ADDRESS
CITY
ADDRESS
/
QUANTITY
ITEM OR PART DESCRIPTION
PRICE
DIAGRAM
HERE
HEATING SYSTEM TUNE-UP
вќЏ Clean Smoke Pipe
вќЏ Clean & Vacuum Heating Unit
вќЏ Clean Nozzle Assembly
вќЏ Clean Burner Fan
вќЏ Check Burner Coupling
вќЏ Check Burner Chamber
вќЏ Size & Replace Nozzle
вќЏ Replace Pump Strainer
вќЏ Replace Oil Filter Cartridge
вќЏ Adjust Electrodes & Controls
вќЏ Lubricate: Burner, Circulator
& Power Venter Motor
вќЏ Check Fan Belt
вќЏ Check Air Filter
вќЏ Balance Draft Regulator
вќЏ Check Safety Devices
вќЏ Check Pump Pressure
вќЏ Check for Oil, Air & Water
Leaks
вќЏ Adjust to Maximum Efficiency
вќЏ Efficiency Test
вќЏ Clean Up Work Area
ZIP
SERIAL NUMBER
вќ’ WARRANTY
вќ’ AFTER HOURS
вќ’ AUTO
вќ’ V.O.C.
вќ’ F.C.A.C.
вќ’ WILL CALL
вќ’ C.O.D.
вќ’ N.E.F.W.
вќ’ BRONZE PLAN вќ’ GOLD PLAN
вќ’ SILVER PLAN вќ’ PLATINUM PLAN
PROFESSIONAL DIAGNOSIS
DESCRIPTION
DIAL
781-944-2763
WORK ORDER #
CITY
EFFICIENCY %
EVAPORATOR COIL
THERMOSTAT
STREET
OVERFIRE DRAFT
VOLTS
AMPS
ELECTRICAL CONNECTIONS
CONTACTS TIGHT & CLEAN
FAN PULLEYS (ADJUST BELT)
CHECK, LUBE BEARINGS & MOTOR
OILHEAT
www.cainoil.com
DATE
PHONE
NAME
BREECH DRAFT
CHARGE
FAN AND MOTOR
CLEAN COIL & CHECK FIN
ENT DB
ЛљF LVG DB
ENT WB
ЛљF LVG WB
O2
SMOKE
Safe•Comfortable
WORK ORDERS
18301
EFFICIENCY
NET STACK
REFRIGERANT
O.K.
RELOCATE
DIAL
GROSS STACK
CONDENSER COIL
RELAYS
OVERLOAD
www.cainoil.com
ITEM OR PART DESCRIPTION
SUCTION
PSI
HEAD
PSI
VOLTS
AMPS
ELECTRICAL CONNECTIONS
CONTACTS TIGHT & CLEAN
CLEANED
OILHEAT
781-944-2763
COMPRESSOR
LEAK
ASK ABOUT AIR CONDITIONING AND
PLUMBING SERVICES.
NAME
EMAIL ADDRESS
CITY
CHECK LIST
SELECTTHEOILBURNERMAINTENANCEAND
SERVICEAGREEMENTPLANTHATSUITSYOUBEST.
Safe•Comfortable
18 GOULD STREET
READING, MA 01867
PLAN4
ADDRESS
PLAN3
NAME
PLAN2
PLAN1
18 GOULD STREET
READING, MA 01867
is professionally trained
and certified and we offer
unmatched customer service.
ASK ABOUT AIR CONDITIONING AND
PLUMBING SERVICES.
REORDER FROM WEHOF FORMS • 800-221-1209
DETACH AND RETURN CARD WITH YOUR CHOICE OF PLAN & PAYMENT.
*CALLFORANAPPOINTMENT.*
OIL BURNER MAINTENANCE
AND
SERVICE AGREEMENT
24HOURBURNERSERVICE
EXPERIENCEDSERVICEENGINEERS
COMPLETEHEATINGINSTALLATIONS
DOMESTICWATERINSTALLATIONS
BOILERANDHOTAIRFURNACESINSTALLED
AIRCONDITIONING
PLUMBING
PLAN1
•
•
•
•
•
•
•
•
DETACH AND RETURN CARD WITH YOUR CHOICE OF PLAN & PAYMENT.
*CALLFORANAPPOINTMENT.*
CUSTOMER SERVICES
ACCEPT DECLINE
PRICE
LINE
TOTAL
PRICE
LINE
TOTAL
SAFETY TIMING
TIME
SEC.
DISPATCHED
ON-JOB
BOILER
COMPLETED
WORK ORDER STATUS
вќ’ COMPLETED _______ вќ’ CALL CUSTOMER
вќ’ NEEDS QUOTE
вќ’ INCOMPLETE
вќ’ NEEDS RETURN VISIT вќ’ ORDER PARTS
вќ’ PO#
вќ’ PARTS ON ORDER
PSI
FUEL TANK READING
FUEL OIL
IN.
TYPE OF SYSTEM
REPAIR NUMBER
WORK PERFORMED
DESCRIPTION
CONDENSING UNIT
вќЏ Check Refrigerant Charge
вќЏ Check & Record System
Pressure Levels
вќЏ Check Contactor Function
вќЏ Check Wiring Connections
вќЏ Check Line-Set Connections
вќЏ Check Condenser Blower
Motor and Fan
вќЏ Clean Debris From Condenser
Fan and Coil
ENVIRONMENT CHECK LIST
CHRG.
CODE
TYPE
SYSTEM
REFRIG.
QTY.
1
RECOVERED?
2
RECYCLED?
3
RECLAIMED?
RETURNED TO
THIS SYSTEM?
4
DISPOSAL
YES
NO
YES
NO
YES
NO
YES
NO
QTY.
QTY.
QTY.
QTY.
PARTS WARRANTY
All parts replaced by Fuel Services
are covered by a one-year warranty.
This guarantee is three to four times
longer than the industry average! If
the part needs to be replaced before
the warranty expires, you will pay
nothing for the repair.
LABOR GUARANTY
The labor charge as recorded here CUSTOMER
relative to the equipment serviced
as noted, is guaranteed for a period REQUEST:
of 30 days.
We do not, of course, guaranty other
parts than those we install. If repairs
later become necessary due to other TECHNICIAN
defective parts, they will be charged SIGNATURE:
separately.
OUR TRAINED PERSONNEL SUGGEST
THE FOLLOWING IMPROVEMENTS:
TOTAL OTHER
CHARGES
________________________________________________________________________
AUTHORIZED SIGNATURE
X
FRONT
(BE SURE TO ADD IN ON OTHER SIDE)
NOTES:
HEATING INFO
Last Service: ____/____/____
Boiler: вќЏ Furnace: вќЏ
S.S. #:______________________________
Brand: ______________________________
BTU Rating: _________________________
Volts:_______________________________
Install Date: ____/____/____
Motor Speed: 1725 вќЏ
3450 вќЏ
Blower Type: Belt: вќЏ Direct: вќЏ
Pump Style: _________________________
Oil Filter Type: _______________________
Burner Type:_________________________
Nozzle Size: _________________________
Air Filter Size:________________________
NO. of Zones:________________________
Circulator Type: ______________________
Safety Type: 8184: вќЏ Stack: вќЏ
Benefits of Quality Service Pricingв„ў
TAX
TOTAL
AMOUNT
DUE
вћ¤
THIS IS YOUR INVOICE.
/
THE ABOVE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY.
CUSTOMER RESPONSIBLE FOR SCHEDULE OF REWORKS.
ADDITIONAL PARTS
SUB-TOTAL
DIAGNOSTIC CHARGE
PRE-AUTHORIZATION
I HAVE THE AUTHORITY TO ORDER THE ABOVE WORK AND DO SO ORDER AS
OUTLINED ABOVE. IT IS AGREED THAT THE SELLER WILL RETAIN TITLE TO ANY
EQUIPMENT OR MATERIAL FURNISHED UNTIL FINAL AND COMPLETE PAYMENT
IS MADE, AND IF SETTLEMENT IS NOT MADE AS AGREED, THE SELLER SHALL HAVE
THE RIGHT TO REMOVE SAME AND THE SELLER WILL BE HELD HARMLESS FOR ANY
DAMAGES RESULTING FROM THE REMOVAL THEREOF.
/
We have chosen to utilize Quality Service
Pricingв„ў, a service provided by a national company that
is the leader in supplying repair tasks to the industry. Our
Quality Service Pricingв„ў program provides the fairest
and the most accurate method of service pricing to our
customers. By using this service, you:
•Knowthecostoftherepairbefore the service
technicianstartsthework.
•Havetheopportunitytoacceptordecline
every repair.
•HaveNO billing surprises.
•Areofferedacapped,not to exceed service
price prior to repair.
•Knowthatthetimeyouarepayingforisa
national standard,baseduponwhatthe
entire industry uses to perform similar repairs.
HOT WATER INFO
Oil: вќЏ Gas: вќЏ Electric: вќЏ Propane: вќЏ
Size: _______________________________
S.S. #:______________________________
Install Date: ____/____/____
Brand:______________________________
Burner Type:_________________________
Pump Style: _________________________
Nozzle Size: _________________________
Aqua-booster:
Tank Size: 275: вќЏ
330: вќЏ
NO. of Tanks:________________________
Tank Filter: Yes: ______ No: ______
ENVIRONMENT
Air Handler Unit
вќЏ Check or Replace with
Customer Supplied Air Filters
вќЏ Check & Clean Heating Coil
вќЏ Check Evaporator Coil for Dirt
Buildup
вќЏ Check Condensate Drain Line &
Connections
вќЏ Check Condensate Drain Pan
for Corrosion
вќЏ Check Condensate Pump
вќЏ Check All Drain Lines
вќЏ Check Fan Belts for Wear
вќЏ Check & Clean Blower Hood
Fan
Inthecaseofrefrigerantleakrepairs,ourpartsandlaborwarrantyissubjecttothefollowingclarifications:
a.Youarestronglyurgedtoletthetechnicianshowyouthelocationoftheleakpriortoandaftertherepair.Ifthisisnotpossibleduetoaninconvenientlocation,besure
thetechnicianaccuratelydescribestheleaklocationonhisserviceticket.Ourwarrantyisforthespecificleakrepaired.
b. Unfortunately, many times there can be more than one leak in a system. We may only locate one and complete an effective repair only to be called out again later and
findanotherone.Ourwarrantyonthepreviousleakrepairwouldnotcoverthenewone.However,ifwithin________daysofthefirstleaklocation,wewillprovidea
nochargediagnosticandleaksearch.Youwillthenonlypayfortherepairoftheleak,justasyouwouldhavedoneifwehadlocateditonthefirsttrip.
BACKER
www.FormsPro.net
7
8
CUSTOM PRODUCTS - PROPANE FORMS
STATEMENTS
STA
STATEMENT
в—Џ
в—Џ
14219 Lagrange Road • LaGrange, Ohio 44050
(440) 458-5155 • 800-537-9164
в—Џ
в—Џ
в—Џ
ACCOUNT NO.
в—Џ
STATEMENT CLOSING DATE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
$
PLEASE RETURN TOP PORTION WITH REMITTANCE
DESCRIPTION
REFERENCE
DATE
GALLONS
в—Џ
AMOUNT ENCLOSED
CREDITS & PAYMENTS
CHARGES
BALANCE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
TERMS NET
в—Џ
в—Џ
From meter tickets to magnets, invoices
to envelopes, or anything in between, we
can duplicate or improve your present
custom forms. Our knowledge of the
industry helps us deliver the appropriate
form for the task at hand. Send us a
sample and let us do the rest.
в—Џ
в—Џ
DEPOSIT BALANCE
REGULAR PAST DUE BALANCE
60 DAYS
CURRENT REGULAR
CHARGES
30 DAYS
CURRENT BUDGET
PAYMENT
PAST DUE
BUDGET PAYMENT
TOTAL BUDGET
PAYMENTS DUE
в—Џ
PLEASE PAY
THIS AMOUNT
90 DAYS
в—Џ
в—Џ
TOTAL NON-BUDGET
CHARGES
в—Џ
в—Џ
в—Џ
в—Џ
INVOICES
в—Џ
в—Џ
в—Џ
в—Џ
INVOICE
SOLD TO:
C
в—Џ
BILLING DATE
ACCOUNT NO.
O
в—Џ
O E
NO
E E
I
O
E
O
E
NO
O
I E
NO
E C I
E
E
C
ION
NI
$
в—Џ
в—Џ
AMOUNT REMITTED
в—Џ
в—Џ
PLEASE DETACH AND RETURN WITH YOUR PAYMENT
в—Џ
DESCRIPTION
CHARGES
PAYMENTS
BALANCE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
800-221-1209
в—Џ
в—Џ
в—Џ
CURRENT
ACCOUNT
STATUS
30 DAYS
>
ALL WEATHER PROPANE
90 DAYS
TERMS: **2% Late Charge on balances outstanding more than 30 days
from date of delivery/sale/service** (24% per annum) Minimum charge $1.00.
Tel: 573-682-2415
в—Џ
60 DAYS
E
E
SHIP TO:
в—Џ
DATE
INVOICE NO
в—Џ
210 N. Howard Burton • PO Box 103 • Centralia, MO 65240
Tel: 573-682-2415 • 888-415-1407
Fax: 573-682-2140
в—Џ
INVOICE
8001 Brownleigh Drive
Raleigh, NC 27617
(919) 787-2242 • (800) 334-5886
FAX (919) 783-0239
в—Џ
INVOICE/STATEMENT
REORDER FROM WEHOF FORMS 800-221-1209
в—Џ
WEHOF FORMS
WEHOF FORMS
800-221-1209
в—Џ
This is a small sample of
cus tom forms for the
propane indus t r y. Gi ve us a
call wi th your nee ds!
THANK YOU
TICKET #
NO
NE
ICE
DESCRIPTION
QUANTITY
UNIT PRICE
AMOUNT
ACCOUNT NUMBER INVOICE TOTAL
BILLED TO:
See reverse side
INVOICE
TERMS: PAYABLE
ON RECEIPT
IMPORTANT: KEEP ORIGINAL COPY - RETURN YELLOW COPY WITH PAYMENT
E
O N
EI
E
TERMS
в—Џ
O N
O
ECEIVE
NCE
E
PLEASE DETACH HERE AND RETURN WITH PAYMENT. (WE DO NOT SEND MONTHLY STATEMENTS)
в—Џ
C
O E
NO
INVOICE NO
INVOICE
8001 Brownleigh Drive
Raleigh, NC 27617
SLIP TICKETS
E
COMMENTS
в—Џ
AMOUNT DUE
DATE
E O
ICE
201 CHURCH STREET • YALESVILLE, CT 06492
(203) 269-2082 • 1-800-356-2213
Fuel Oil • Propane • Diesel Fuel • Kerosene • Gasoline
NCE
E
E
REORDER FROM WEHOF FORMS (800) 221-1209
VOLUME CORRECTED TO 60Вє F.
UN1075 LIQUID PETROLEUM GAS
INSERT FACE UP
MID:COM ONLY
REORDER FROM WEHOF FORMS 800-221-1209
WEHOF FORMS 800-221-1209
P.O. BOX 312, PRINCETON, KY 42445
PRINCETON:
800-455-4427
CADIZ:
800-535-4427
MADISONVILLE: 866-846-4427
UN-1075
Portsmouth 431-3199
Seabrook 474-7667
Newmarket 659-7011
Rochester 330-0011
Rev. Act of 1935 Amending 1932 Act Under Sec. 617(c) (2)
The undersigned purchaser hereby certifies that the Butane-Propane mixture delivered on this order
will not be used for the propulsion of any motor vehicle, motor boats, or airplanes, or used in the
manufacture of a fuel for such purposes.
The undersigned understands that the use of the Butane-Propane mixture in any of the above usages
is subject to the tax for such use, and fraudulent use of this certificate to secure exemption will subject
the undersigned to a fine of not more than $10,000.00 or to imprisonment for not more than five years,
or both, together with the costs of prosecution. The undersigned also understands that he must be
prepared to establish by competent evidence that the Butane-Propane mixture was actually used for
the purpose of _____________________________________________________________________.
L.P. Gas Gallons Automatically Corrected to 60П’ F.
www.fortnergas.com
вќЏ
✶✯✬✵✭✥✡✤✪✵✳✴✥✤ ✯
вњґ вњ–вњђ
вњ¦вњЋ
CUST # ________________________________ DATE ___________________ 20 ____________
BLUE FLAME GAS
A DIVISION OF MID-STATE ENERGY, INC.
1130 NORTH SCENIC HWY. LAKE WALES, FL 33853-3249
676-2917 • 676-3910 • 676-1791 • 422-3415 • 24 HRS. 676-1791
SOLD TO
Sold to
вќ’ COD
вќ’ CHARGE
ADDRESS
Address
TRUCK NO.
PAID
CHARGE
Phone No.
In the event of default, Fortner LP Gas Co., Inc. will be
entitled to reasonable attorney fees and court costs.
Customer Signature
INVOICE
NO.
вћЎ
Date
GALS. READING – START
GALS. READING – FINISH
SALES SEQUENCE NUMBER
PRICE PER GALLON – CENTS
PRODUCT COST
TAX
TOTAL PRICE
No 63001
P.O. Box 419, Newmarket, NH 03857
FUEL OIL • PROPANE • KEROSENE • BLEND • DIESEL FUEL
вќ’ CASH
вќ’ CHECK
вќ’ MC
вќ’ VISA
PLEASE PAY FROM THIS INVOICE.
NO OTHER WILL BE SENT.
PRE. BALANCE / CREDIT $
TOTAL AMOUNT DUE
в–ј CERTIFIED METER READING в–ј
PHONE NO.
TRUCK NO.
DRIVER
PRODUCT
GALLONS
PRICE
TIME
AM
PM
AMOUNT
TRANS. SURCHARGE
P.E.R.C.
TAX
TAX
TAX
PAYMENT RECEIVED
$ ______________________
CUSTOMER SIGNATURE
X
вќ’ CASH вќ’ CHECK
TOTAL
NO STATEMENT WILL BE SENT. THIS IS THE ONLY BILL YOU WILL RECEIVE FOR
YOUR L.P. GAS. PAYMENT MUST BE MADE WITHIN 10 DAYS OF DELIVERY.
MIDSTATE ENERGY SMT(BLUE FLAME).indd 1
10/17/08 8:49:51 AM
TO ORDER CALL
$
RECEIVED ON ACCOUNT $
DYED DIESEL FUEL, HEATING OIL
NON-TAXABLE USE ONLY, PENALTY FOR TAXABLE USE.
800-221-1209
Exeter 778-8308
Kittery 439-3881
Dover 742-2621
York 363-3636
ALL INVOICES ARE DUE UPON RECEIPT
FINANCE CHARGES ON UNPAID BALANCE WILL START 30 DAYS AFTER DELIVERY
DATE. DELINQUENT ACCOUNTS WILL BE REFERRED TO AN OUTSIDE AGENCY
FOR COLLECTION OR PLACED WITH DISTRICT COURT.
Any collection costs, attorney’s fees and court costs will be added to the total amount due
and is the sole responsibility of the customer.
IN CASE OF ERRORS OR INQUIRES ABOUT YOUR BILL
If you want to preserve your rights under the Fair Billing Credit Act, here is what you
need to do if you think your bill is wrong or if you need more information about an item
on your bill.
CUSTOM PRODUCTS - PROPANE FORMS
9
METER TICKETS
Do not write on this bill. On a separate piece of paper write the following
a. Your name and account number.
b. A description of the error and an explanation of why you believe it is an error.
c. The dollar amount of the suspected error.
d. Any other information which you think will help us to identify you or the reason
for your complaint.
e. Send the billing error notice to: Florida Public Utilities, PO Box 2057, Salisbury, MD
  21802-2057 before 60 days from the date of this invoice.
THERMAL ROLL TICKETS
(available with
CME
bilingual backers)
How To Close Gas Supply Valves
THERMAL
ROLL
TICKET
A
METER READING HAS BEEN ADJUSTED TO THE VOLUME AT 60ВєF.Propane
PROPANE HAS AN UNUSUAL ODOR, SIMILAR TO ROTTEN EGGS
Propane is heavier than air: therefore, leaks will tend to settle to floor or basement levels.
To check for propane, carefully smell in low spots. Colds, allergies, sinus congestion
and the use of tobacco, alcohol or drugs may diminish your sense of smell. Cooking or
other strong odors may cover up the smell of gas. On rare occasions, propane gas may
lose its distinctive smell - this is called “ODORANT FADE”. Sometimes propane gas can
lose its odor if a leak occurs underground. Some persons are physically unable to detect
the smell of gas. If you are one of those people call us immediately. For these reasons,
we recommend that you install a propane gas detector according to the manufacturer’s
instructions.
WHAT TO DO IF YOU SMELL GAS...
1. Put out all smoking materials and other open flames.
2. DO NOT operate a light switch, telephone, cigarette lighter, appliance or
thermostat. Any spark in the area where propane gas is present may ignite the gas.
3. Get EVERYONE out of the building immediately.
4. Shut off gas supply at the tank or cylinder (see below).
5. Call your gas supplier - use your neighbor’s phone if gas odor is in the building.
6. Have your propane gas service person locate and repair the leak, check and
re-light your gas appliance and air out the area before you return.
Instruciones Para Cerrar La Valvula De Seguridad
Turn shu
Apagar la t of
va
e clockwise
alv acia la d to c
ere l
f v ula h
lv
Shut off
valve here
Apagar la
valvula aqui
e
os ha
c
Shut off valve here
Apagar la valvula aqui
None of the HAZMAT or Fuel Surcharge fees represent a tax or fee paid to or imposed
by any governmental authority and all of the charges are retained by the Company. The
Company has not specifically quantified the relationship between the fees and the actual
costs associated with the fee, which can vary by product, service, time and place, among
other things.
TERMS AND CONDITIONS
ALL INVOICES ARE DUE UPON RECEIPT
FINANCE CHARGES ON UNPAID BALANCE WILL START 30 DAYS AFTER DELIVERY
DATE. DELINQUENT ACCOUNTS WILL BE REFERRED TO AN OUTSIDE AGENCY
FOR COLLECTION OR PLACED WITH DISTRICT COURT.
Any collection costs, attorney’s fees and court costs will be added to the total amount due
and is the sole responsibility of the customer.
IN CASE OF ERRORS OR INQUIRES ABOUT YOUR BILL
If you want to preserve your rights under the Fair Billing Credit Act, here is what you
need to do if you think your bill is wrong or if you need more information about an item
on your bill.
a. Your
and account
number.
EL PROPANO TIENE UN OLOR PECULIAR, SIMILAR
Aname
UN
HUEVO
PODRIDO.
b. A description of the error and an explanation of why you believe it is an error.
c. The dollar
amount of the suspected
error.
El propano es mГЎs pesado que el aire y por lo tanto las fugas
tienden
a asentarse
sobre
d. Any other information which you think will help us to identify you or the reason
complaint.
el piso o niveles del sГіtano. Para comprobar si hay fugae. for
deyourthepropano,
cuidadosamente
Send
billing error notice to:
Florida Public Utilities, PO Box 2057, Salisbury, MD
  21802-2057 before 60 days from the date of this invoice.
inhale en niveles bajos. Resfriados, alergias, congestions METER
de READING
la sinus,
y elTOuso
deAT 60ВєF.
HAS BEEN ADJUSTED
THE VOLUME
tabaco, alcohol o drogas pueden disminuir sus sentidos del olfato.
El
cocinar
u
otros
How To Close Gas Supply Valves
Instruciones
La Valvula
De Seguridad
olores fuertes pueden disfrazar el olor de gas. En raras ocasiones
elPara
gasCerrar
propano
puede
perder su olor distintivo – a esto se le llama �DESVANECIMIENTO DE ODORANTE’ .
Aveces el gas propano puede perder su olor si ocurre una fuga subterrГЎneanea. Hay
personas que fГ­sicamente no pueden detectar el olor de gas. Si es Гєsted una de estas
personas llamenos inmediatamente. Por estas razones recomendamos instale un
detector de gas propano de acuerdo a las instrucciones del fabricante.
EL PROPANO TIENE UN OLOR PECULIAR, SIMILAR A UN HUEVO PODRIDO.
QUE HACER SI HUELE GAS…
El propano es mГЎs pesado que el aire y por lo tanto las fugas tienden a asentarse sobre
el piso o niveles del sГіtano. Para comprobar si hay fuga de propano, cuidadosamente
1. Apague todo material de fumar y cualquier llama expuesta.
inhale en niveles bajos. Resfriados, alergias, congestions de la sinus, y el uso de
tabaco, alcohol o drogas pueden disminuir sus sentidos del olfato. El cocinar u otros
olores fuertes
pueden disfrazar
de gas. En raras ocasiones el gas propano puede
2. NO opere ningГєn interruptor de luz, telГЁfono, cigarrillo,
enceres,
orel olor
termostato.
perder su olor distintivo – a esto se le llama �DESVANECIMIENTO DE ODORANTE’ .
Aveces el gas propano puede perder su olor si ocurre una fuga subterrГЎneanea. Hay
Cualquier chispa en el area donde haya propano presente
puede encender el gas.
personas que fГ­sicamente no pueden detectar el olor de gas. Si es Гєsted una de estas
personas llamenos inmediatamente. Por estas razones recomendamos instale un
3. EvacГєe a todos del edicficio inmediatamente.
detector de gas propano de acuerdo a las instrucciones del fabricante.
QUE HACER SI HUELE GAS…
4. Cierre el suministro de gas en el tanque o cilindro (vea
dibujo
a deseguir)
1. Apague
todo material
fumar y cualquier llama expuesta.
2. NO opere ningГєn interruptor de luz, telГЁfono, cigarrillo, enceres, or termostato.
Cualquier chispa
en el area
donde haya
propano en
presente
5. Llame a su suplidor de gas – use el telèfono de un vecino
si hay
olor
a gas
supuede encender el gas.
3. EvacГєe a todos del edicficio inmediatamente.
4. Cierre el suministro de gas en el tanque o cilindro (vea dibujo a seguir)
edificio.
5. Llame a su suplidor de gas – use el telèfono de un vecino si hay olor a gas en su
edificio.
6. Requiera del tГЁcnico de servicio que localize y repare
la fuga,
ylocalize
vuelva
afuga, revise y vuelva a
6. Requiera
del tГЁcnicorevise
de servicio que
y repare la
encender su aparato de gas, y ventile el area previo a su regreso al edificio.
encender su aparato de gas, y ventile el area previo a su regreso al edificio.
Do not write on this bill. On a separate piece of paper write the following
D i s p l ay
Yo u r
C omp any
Logo!
SNAPSET
METER
TICKET
Turn shu
Apagar la t of
va
e clockwise
alv acia la d to c
ere l
f v ula h
lv
e
os ha
c
Shut off valve here
Apagar la valvula aqui
Shut off
valve here
Apagar la
valvula aqui
NingГєn cargos de Materiales Peligrosos (HAZMAT) o Combustile representan
impuestos o cargos pagados o impuestos a autoridades gubernamentales y todos los
cargos son retenidos por la compania. La compaГ±Г­a no ha cuantificado especГ­ficamente
la relacion
entre
los cargos y los costos actuales
asociados con los cargos, los cuales
NingГєn cargos de Materiales Peligrosos (HAZMAT)varГ­an
opor producto,
Combustile
representan
servicio, tiempo y lugar, entre otras cosas.
impuestos o cargos pagados o impuestos a autoridades gubernamentales
y todos los
TERMINOS Y CONDICIONES
TODA FACTURA DEBE PAGARSE AL RECIBIRSE
cargos son retenidos por la compania. La compaГ±Г­a no ha
cuantificado
especГ­ficamente
CARGOS
DE FINANZA SE INCIAN
30 DIAS DESPUES DE LA FECHA DE ENTREGA
PARA SALDOS PENDIENTES.
la relacion entre los cargos y los costos actuales asociados
con los cargos,
losA TERCEROS
cuales
CUENTAS DELINCUENTES
SERAN REFERIDAS
PARA COLECCION
O A LA CORTE DEL DISTRITO.
Gastos
de colecciГіn, abogados y corte serГЎn aГ±adidos al monto total debido y serГЎ la
varГ­an por producto, servicio, tiempo y lugar, entre otrasresponsbilidad
cosas.
total del cliente.
EN CASO DE ERRORES O PREGUNTAS SOBRE SU FACTURA
Si desea conserver sus derechos bajo el acto “Fair Billing Credit” a seguir estan las
instrucciones si cree que su cuenta estГЎ incorrecta o si necesita mas informaciГіn.
TERMINOS Y CONDICIONES
No escriba en esta cuenta. En un papel separado escriba lo siguiente:
a. Su
nombre y nГєmero de cuenta
TODA FACTURA DEBE PAGARSE AL
RECIBIRSE
b. Una descripciГіn del error y explicaciГіn del mismo
cantidad
monetaria
del error DE ENTREGA
CARGOS DE FINANZA SE INCIAN 30 DIAS DESPUESd.c. LaCualquier
DE
LA
FECHA
otra informaciГіn que nos ayude a identificarlo o la razГіn de la queja
EnvГ­e la factura y su carta a: Florida Public Utilities, PO Box 2057 Salisbury, MD
PARA SALDOS PENDIENTES.
21802-2057
e. Dentro de 60 dias de la fecha de la factura
CUENTAS DELINCUENTES SERAN REFERIDAS A TERCEROS
PARA COLECCION
LA LECTURA DEL CONTADOR HA SIDO AJUSTADA AL VOLUMEN DE 60F.
O A LA CORTE DEL DISTRITO.
Gastos de colecciГіn, abogados y corte serГЎn aГ±adidos al monto total debido y serГЎ la
responsbilidad total del cliente.
EN CASO DE ERRORES O PREGUNTAS SOBRE SU FACTURA
Si desea conserver sus derechos bajo el acto “Fair Billing Credit” a seguir estan las
instrucciones si cree que su cuenta estГЎ incorrecta o si necesita mas informaciГіn.
REORDER FROM WEHOF FORMS 1(800) 221-1209
в—Џ
ACCOUNT
CI
PHONE
ZO
TERMS
LIQUEFIED PETROLEUM GAS/FLAMMABLE GAS/PROPANE/ UN 1075 NON-CORROSIVE
10ths
GALLON READING FINISH
BILLING ADDRESS
CODE
INSTRUCTIONS
PREVIOUS SALE NO.
BILL TO
ADDRESS
DELIVERY ADDRESS
GALLON READING START
WEHOF FORMS 800-221-1209
OFFICE
ADDRESS
DELIVERY ADJUSTED TO 60П’ F.
No escriba en esta cuenta. En un papel separado escriba lo siguiente:
a. Su nombre y nГєmero deв—Џcuenta
GALLONS
DEGREE DAYS
DATE LAST
b. Una descripciГіn del error y explicaciГіn del mismo
c. La cantidad monetaria del
START % – END %
PRESSURE TEST
в—Џ error
d. Cualquier otra informaciГіn que nos ayude a identificarlo o la razГіn de la queja
PSI
MIN
FC
EnvГ­e la factura y su carta
MD PROPANE PRINTED
RELIANCE
в—Џ a: Florida Public Utilities, PO Box 2057 Salisbury,
6434 SKYWAY
PARADISE, CA 95969
21802-2057
(530) 872-7740
GALLONS
PRICE
PARADISE
e. Dentro de 60 dias de laв—Џfecha de la factura
(530) 343-8547
OIL & PROPANE
CHICO
FAX (530) 872-8951
FROM
в—Џ
в—Џ
YOUR SALE NO.
в—Џ
LA LECTURA DEL CONTADOR
HA SIDO AJUSTADA AL VOLUMEN DE 60F.
DELIVERY
ADDRESS
WHAT TO DO IF YOU SMELL GAS…
A Lot
в—Џ
AMOUNT
CHECK
PAYMENT
PAY THIS AMOUNT
CASH
THIS IS YOUR INVOICE.
WORK ORDERS
1. Put out all smoking materials and other open flames.
2. DO NOT operate a light switch, telephone, cigarette lighter, appliance or
thermostat. Any spark in the area where propane gas is present may ignite
the gas.
3. Get everyone out of the building immediately.
4. Shut off the gas supply at the tank or cylinder. (See below.)
More
Than
Fuel
How to Close Gas Supply Valves
INVOICE
REORDER FROM WEHOF FORMS (800) 221-1209
AMOUNT
UN1075
Undyed diesel,
contains no
visible evidence
of dye.
5. Call 911 and your local Dealer - Use your neighbor's telephone if gas odor
is in the building.
6. Have your service person locate and repair the leak. Have your service
person air out the area and check and re-light your gas appliances. Do not
return to the building until you are advised that all leaks have been repaired
and it is safe to return.
вќ’
This diesel fuel
meets all EPA
requirements for
sulphur, cetane
or aromatics.
For your safety, propane has an odor added so you can detect leaks. You and
each person using or handling propane in your household must know the smell
of propane. Ask for a scratch 'n sniff brochure or MSDS to demonstrate the odor.
If anyone is unable to recognize the odor of propane, call us immediately.
вќ’
If ____ checked,
off highway/not
legal for motor
vehicle use.
вќ’
All gasoline
is detergent
additized.
WORK ORDER
OFFICE COPY
77 HIGHWAY 25 SOUTH
WAYNESBORO, GA 30830
1-800-387-1362
CUSTOMER
NUMBER:
DATE:
CUSTOMER NAME
ADDRESS
CITY
HOME PHONE NO.
ST.
BUSINESS PHONE NO.
ZIP
SOCIAL SECURITY NO.
ROUTE #
LOCATION DESCRIPTION / DIRECTIONS
Propane vapors are heavier than air, spread rapidly, and migrate in all
directions. To check for propane, carefully smell in low spots.
PLEASE PAY THIS AMOUNT
BEAR DOWN
LP–GAS • EQUIPMENT • SERVICE
OIL & PROPANE
DESCRIPTION OF CHARGE
PO BOX 16108
DULUTH MN 55816-0108
UN1203
NA1993
в—Џ
SUB TOTAL
PLEASE PAY FROM THIS INVOICE
WORK TO BE DONE / REMARKS
Under some of the following conditions, you may not be able to smell a gas leak.
For example:
APPLIANCES
Age, colds, allergies, sinus congestion or the use of tobacco, alcohol or
drugs may diminish your sense of smell.
QTY.
TAG NUMBER
MODEL NUMBER
DESCRIPTION
UNIT PRICE
AMOUNT
Cooking or other strong odors may cover up the smell of gas.
In certain circumstances, propane gas may lose its distinctive smell - this
is called "ODORANT FADE".
A
PARTS AND MATERIALS
Sometimes propane gas can lose its odor if a leak occurs underground.
RECEIVED PAYMENT OF $ ________________Some persons are physically unable to detect the smell of gas. If you are
QTY.
PART OR MODEL #
APPLIANCE
SUB TOTAL
DESCRIPTION
UNIT PRICE
AMOUNT
one of these people, call us immediately.
PLEASE SEE REVERSE FOR IMPORTANT INFORMATION.
PLACE
STAMP
HERE
FRONT
For these reasons, it is recommended that you purchase and install a propane
gas detector according to the manufacturer's instructions as a back-up
warning device. If anyone using or handling propane is unable to recognize the
odor of propane, you should not use it until you have purchased and installed
gas detector(s).
TERMS: Payment due upon delivery of product. A FINANCE CHARGE of 11вЃ„2%
per month, which is an ANNUAL PERCENTAGE RATE of 18%, will be charged
on the balance remaining unpaid over 30 days past the invoice date. The
minimum monthly finance charge will be 50Вў. A $30 service charge will be
added to all dishonored checks.
NO
OPERATION OF SYSTEM EXPLAINED TO CUSTOMER
CHECKED EQUIPMENT OPERATION
вќ’ CHARGE
вќ’ C.O.D.
❒ REC’D ON ACCT.
C
D
%
COMPANY TANK
CHECK #
вќ’
METER NO.
CUSTOMER TANK
вќ’
вќ’
USED
вќ’
(
) GALS.
E
F
G
METER READING
MFG. BY
TAXABLE SUB-TOTAL
SALES TAX
LABOR
TOTAL
YEAR MFG.
SIZE W.C.
ENVELOPE
NEW
PARTS & MATERIALS
SUB TOTAL
LEASE CHARGES
GAS
(TOTAL OF
A, B, C & D)
TANK SERIAL NO.
PROPANE
BACKER
B
PAYMENT METHOD
YES
CUSTOMER RECEIVED SCRATCH & SNIFF
REG. DATE
W.P.
PIPING PRESSURE & LEAK TEST
THIS IS YOUR INVOICE – PLEASE PAY THIS AMOUNT
SINGLE STAGE
REGULATOR OPERATION
TWO STAGE
FIRST STAGE
PRESSURE
SECOND OR SINGLE STAGE
TIME
START ______
вќ’ PSIG ______ вќ’вќ’ AM
PM
FINISH ______
вќ’ PSIG ______ вќ’вќ’ AM
PM
PRESSURE
START ______
FINISH ______
START ______
FINISH ______
THIS ORDER SUBJECT TO CORRECTION OF ERRORS IN
PRICE AND EXTENSION.
www.FormsPro.net
TIME
вќ’ PSIG ______ вќ’ AM
вќ’ PSIG ______ вќ’ PM
вќ’ IN WC ______ вќ’ AM
вќ’ IN WC ______ вќ’ PM
SINGLE STAGE
SYSTEM
TWO STAGE
SYSTEM
REGULATOR
DATE CODE
MNLCTR.
MODEL
REG. VENT
POSITION
FLOW
PRESSURE
LOCK UP
PRESSURE
REGULATOR
DATE CODE
MNLCTR.
MODEL
REG. VENT
POSITION
FLOW
PRESSURE
LOCK UP
PRESSURE
FIRST STAGE
SECOND STAGE
ALL NEW MERCHANDISE SOLD HEREIN IS GUARANTEED TO THE EXTENT OF
THE MANUFACTURER’S WARRANTY ONLY. NO WARRANTY OF ANY KIND ON
USED MERCHANDISE UNLESS SPECIFIED IN WRITING HEREIN.
PSIG
PSIG
IN W.C.
IN W.C.
TERMS OF THIS AGREEMENT ARE UNDERSTOOD AND ACCEPTED.
в—Џ
DATE
BALANCE
DEL. DATE
в—Џ
DRIVER
SAFETY NOTICE
Delivering
вќ’
вќ’
вќ’
вќ’
JULIAN
SALES TAX
TICKET
NO.
RECEIVED BY
TERMS - NET 10 DAYS
BALANCE
в—Џ
в—Џ
в—Џ
в—Џ
CUSTOM PRODUCTS
POLY BAGS
BEST
BAG IN THE
INDUSTRY!
вќ– thicke r
вќ– higher clar i t y
вќ– s t ronger plas t ic handle
PROTECTIVE
POLY COVERING
вћЄ
INSERT FACE
UP
The 11⁄2” diameter hole is located 11⁄2”
from the top of the bag. The bags are
top mounted to a sturdy, plastic tearoff header in packs of 100. Made from
a low density poly for crystal clear seethru vision; size is 51⁄2” X 161⁄2”.
2000
4000
6000
8000
10000
$ 56.00
$ 104.00
$ 150.00
$ 192.00
$ 230.00
TOP END FIRS
T
REORDER FORM
# 3-ST FROM
WEhOF FORMS
1-800-2 21-1
CERTIFIED
209
METE
R DELIVERY
GALLON READI
NG - START
GALLONS DELIVE
RED
TODAY'S
OIL CO.
10ThS
198 WESTEN
D AVENUE
HOLLINGSW
ORTH, NC
270
01
800-221-7777
SOLD TO
PRODUCT
GALLONS
PRICE
THIS IS YOU
R INVOICE
IN TANK (APPRO
X)
RECEIVED
PAYMENT $
C.O.D.
ChARGE
REC’D ABOVE
CUSTOMER GALS.
SIGNATURE
TAX
вћЎ
TOTAL
DATE
BY
AMOUNT
20
TRUCK
NO.
012
REOR
DER
PROD
UCT
FORM
$
PAY
#AD
ME
NS
Custom printed doorknob
poly bags in either clear
or opaque plastic, with or
without print, one color or
multi-colored. These bags
can be part of a delivery
packet which can add to
your company image and
ensure that your customer
receives all the important
information about their
delivery.
34
CUSTOM DOORKNOB
POLY BAGS
GALLO
DS-MT
NT
RECE
FROM
IVE
PRICE
D
$
WE
HO
F FO
H
CAS
CK
CHE
AM
OU
RM
S
800
L $
TOTA
NT
-221-1
209
$
ET
K
TIC
RY D.
E
IVE
EL CLOS
D
UR S EN
YO
I
DATE
CERT
IFIED
DRIVE
R
ME
TER
READ
ING
. TIM
UCK
E TR
#
IN TAN
K AFT
ER
FU
E
M
C EL
ing
ovid
rt
“Pr comfo
r
”
o
5
o
d
7
n
9
i
e1
sinc
DEL
Available in custom sizes
and thickness. Please call
our sales team to get
quotes or information on
this item.
A
10
TO ORDER CALL
800-221-1209
CUSTOM PRODUCTS
PAYMENT ENVELOPES
DOORKNOB REMITTANCE
ENVELOPE
Size 43⁄8” X 67⁄8” Detached; 24# White Wove
Top
Opening Design
PRICE
   QTY.
1 ctn.    2500
2 ctn.  5000
4 ctn. 10000
PRICE
PER 1,000
  $ 205.00
  $ 360.00
$ 670.00
$ 82.00
$ 72.00
$ 67.00
PLE
Includes your return address
with up to four lines printed in blue ink.
Customer supplied logos & bar codes
at no extra charge.
ASE
USE
F OR THIS
YOU PAYM
E
RR
E MIT NT E N
TA N VE L O
CE .
PE
INV
OIC
EE
NC
LO
SE
D
BEST
VALUE IN THE
INDUSTRY!
WE
HO
FF
ENVELOPE
FRONT
DOORKNOB REMITTANCE
ENVELOPE 2
NEW
Size 43⁄8” X 61⁄2” Detached; 24# White Wove/Brown Kraft
Side Opening Design
   QTY.
PRICE
1 ctn.    2500   $ 187.00
2 ctn.  5000   $ 325.00
4 ctn. 10000
$ 600.00
PRICE
PER 1,000
$ 75.00
$ 65.00
$ 60.00
Includes your return address
with up to four lines printed in black ink
on Front and Back. Customer supplied
logos & bar codes
at no extra charge.
* 2 Color and 4 Color
Orders are Available as
Custom Quote!
www.FormsPro.net
OR
MS
800
-22
1-1
2
09
11
CUSTOM PRODUCTS
DOORKNOB SLIP TICKETS
BACK
FRONT
INSERT THIS SIDE UP
REORDER FROM WEHOF FORMS (800) 221-1209
ALL REMITTANCES AND
INQUIRES SHOULD BE SENT TO:
TREXLER-HAINES, INC.
6635 TILGHMAN STREET
ALLENTOWN, PA 18106
(610) 395-2525 • (215) 679-7909
TOLL FREE: 1-877-TREXLER • PA014729
PROPANE • FINE APPLIANCES
HEARTH PRODUCTS • GRILLS
PLEASE RETURN TOP COPY WITH YOUR PAYMENT.
APPLIANCES
• Kitchen
• Laundry
• Dryers
Safety First, Last and Always
PROPERTIES OF PROPANE GAS:
•Propaneisaflammablegasthatcancausefiresandexplosions.
•Propaneisheavierthanairandcancollectinlowplaces(alongthefloor,
inbasements,etc.)
•Propanehasbeenodorizedsoyoucansmellit.
IF YOU DETECT AN ODOR:
•Openwindowsanddoorstoincreaseventilation.
•DONOTlightmatchesorcigarettes.
•DONOToperateswitches,electricalappliances,thermostatsortelephones.
Theymaycauseasparktoigniteescapinggas.
•Checktobesureallpilotsareburning.
•Ifthesourcehasnotbeendetected,geteveryoneoutofthebuildingand
shutoffthepropanesupplyatthecontainer.
•Callusfromaneighbor’sphone.DONOTgobackinthebuilding.
REMEMBER THIS ABOUT PROPANE’S ODOR:
•Somepeopleareunabletodetecttheodorantingas.
•Colds,allergiesandsinuscongestioncanallaffectyoursenseofsmell.
•Tobaccosmokeorstrongcookingodorscancoverupotherodors.
•Theuseoftobacco,alcoholordrugsmayalsoaffectyoursenseofsmell.
GRILLS
• Gas Grills
IF YOU RUN OUT OF GAS:
•Shutoffthemainsupplyvalveatyourtank(s).Learnwherethissupplyshutoff
valveislocatedbyaskingus.
•Shutoffallapplianceburnersandpilotvalves.Instructionsshouldbeonor
withtheappliance.
•Whengasserviceisrestored,toavoidhazards,haveusturnthevalvesback
on,lightthepilotsandcheckthecontrols.
•Besureallappliancesarechecked.
HEARTH PRODUCTS
• Water Heaters
• Space Heaters
• Pool Heaters
CUSTOM DOORKNOB SLIP
TICKETS WITH
RETURN MAIL ENVELOPES
Now you can le ave your t icke t
se cure ly af ter your de li ver y!
• Works with new electronic metering systems
• Return envelope speeds up your cash flow
• Stock format means its affordable & ships
quickly
• Volume discounts available
REMEMBER:
•NEVERtamperwithyourapplianceandrelatedequipment.Allrepairsmust
bedonebyourqualifiedservicetechnicians.
•Ifappliancecontrolhasbeenexposedtowater—itmustbereplacedby
ourservicetechnicianimmediately.
•Allgasappliancesmustbeinstalledbyqualifiedservicetechnicians.
•DONOTremovegasappliances,asallopengaslinesmustbeplugged,
cappedorremovedcompletely.
CUSTOMER
PROGRAMS
• Prebuy
• Budget
• THInk Tank
• Automatic
Delivery
• Others - Call Us
RETURN ENVELOPE
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO PROPANE
APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
How to Close Gas Supply Valves
FLAMMABLE GAS
- UN1075
(PROPANE - NON
CORROSIVE)
Shut off
valve here
FROM
Shut off
valve here
TERMS:(NotApplicabletoC.O.D.):Paymentsnotreceivedwithin30
days after the delivery or service are subject to finance charges of
1.5%(18%AnnualPercentageRate).Theminimumfinancechargeis
50Вў. Finance charges are computed until the date payment is
received and begin on the date of service or delivery by TrexlerHaines,Inc.(“THI”).THIsuggeststhatyouallowatleast5businessdays
formaildelivery.
FLAMMABLE
COMPRESSED
TEMPERATURE
COMPENSATED
AT 60ЛљF.
PLACE
STAMP
HERE
www.Trexlerhaines.com •
PA014729
FIRST-CLASS MAIL TO:
CHARGES: Customer hereby agrees to pay all amounts due and
owing to THI for the services performed for Customer pursuant to a
fee schedule maintained by THI. In addition to the scheduled fees,
THIreserves the right to bill for costs and delays resulting
fromunforeseenorunknown conditionsofCustomer’spropertyona
timeand materials basis. Fees for services not included on the
schedule shall also be billed on a time and materials basis. The
minimumlaborcharge,iflaborchargesareapplicable,isforone-half
hourandthelaborratechargedperhourissubjecttochangebyTHI.
Anyinformationandquestionsregardingthecurrentlaborratesmay
be obtained by contacting THI’s offices. THI reserves the right to
charge a fee to customer in the event thatTHI makes a scheduled
appointmentatthepropertyandTHIisdeniedreasonableaccessto
perform the scheduled services or is unable to perform scheduled
services through no fault ofTHI.THI also reserves the right to charge
Customer for responses to emergency calls from Customer, which
prove to be“false alarms”. Fees for“non-access and false alarms”
shallbelistedonthefeeschedulemaintainedbyTHI.
See back for
important safety
information.
PROPANE • FINE APPLIANCES
HEARTH PRODUCTS • GRILLS
6635 TILGHMAN STREET
ALLENTOWN PA 18106-9308
Serving the propane community since 1935
DELIVERY AND SERVICE SUSPENSION: Delivery and services may be
suspended if payment in full is not made within 30 days after
delivery.
111001
вќ’
вќ’
вќ’
вќ’
LEAK CHECK
TANK PRESSURE: START_______ END _______ TIME HELD ______
вќ’
PARTIAL FILL _____%
SNIFF TEST
PETROLEUM GAS 2,1 UN 1075
PAYMENT REC’D $____________ DRIVER SIGN.: __________________________
вќ’
CHECK
вќ’
CUST. SIGN.:
CASH
вќ’
PROPANE SPECIALISTS ……… clean, efficient, versatile
HEARTH
& SUPPLEMENTAL HEAT……… warmth, comfort and style
ACCOUNT TERMINATION AND COLLECTION: An Account may be
referredtoacollectionagencyandanaccountmaybeterminated
andallTHIEquipmentremovedifpaymentinfullisnotreceivedwithin
60daysafteradeliveryorserviceprovided.However,ifCustomerhas
givenTHInoticethatitrefusestopayanyoutstandingamountsdue,
THIreservestherighttoremovetheequipment,withinareasonable
time,uponreceiptofsuchnotice.CustomergrantsaccesstoTHIfor
such removal. Customer will be responsible for paying the past due
balance, collection fees and attorneys’ fees, as well as a service
charge or removal fee to remove the Equipment. If Customer
terminatesservicewithTHI,anybalanceonCustomer’saccountwill
becomeimmediatelydueandowing.Equipmentservicechargesor
removalfeesmayalsoapply.
OUTDOOR LIVING
SOLUTIONS……………………… from grills to pool heaters
KITCHEN/LAUNDRY
APPLIANCES………… …………. the finest in the industry
CREDIT CARD
REMOVE THIS STUB TO EXPOSE ADHESIVE TAPE.
FOLLOW INSTRUCTIONS ABOVE.
Shut off
valve here
1. WRITE YOUR ACCOUNT NUMBER ON CHECK.
2. INSERT CHECK INTO ENVELOPE.
3. REMOVE TAPE COVERING GLUE, FOLD OVER & SEAL.
LIQUEFIED
PETROLEUM GAS
вњ—________________________________________________________
OFFICE COPY
INNER ENVELOPE
DOORKNOB HANGERS
Custom doorknob cards available in many sizes. Special features are available
including slits to hold a standard or magnetic business card.
Parker
OIL & PROPANE
OIL
COMP
AN
C
IN
Y,
K
75
ER
.
PAR
12
YEARS
1 9 35
- 2010
“Committed to Safety”
If you smell gas or have an
emergency, please turn your tank
off and use your neighbor’s phone
to call your local office or our toll
free 1-800-486-3146!
Your Business
Card Here
WITH A
BUSINESS
CARD!
Sorry we missed you!
Date _________________________
We arrived at _______________ a.m./p.m.
to deliver your propane, oil, and:
вќ’
вќ’
вќ’
вќ’
Found no one home
Couldn’t find tank
No payment found
Other
At your convenience please call our office
to reschedule your delivery, thank you.
1-877-848-9900
Oil
1-800-639-9976
Propane
WITH A
TO ORDER CALL
800-221-1209 MAGNET
CARD!
CUSTOM PRODUCTS
13
CHECKS
We are specialists in custom printed payable
and payroll checks for:
012345
EST. 1878
FREDERICKS FUEL & Heating Service
517 ROUTE 284, WANTAGE, NJ 07461
P.O. BOX 308 , UNIONVILLE, NY 10988
ONE WRITE PLUS
QUICKEN
QUICK BOOKS
THE ENCLOSED CHECK IS IN FULL PAYMENT OF ITEMS BELOW.
(973) 875-4200
(845) 726-3326
COMPANY
NUMBER
INVOICE
ADJUSTMENT
AMOUNT
INVOICE
AMOUNT
INVOICE
NUMBER
CHECK NUMBER
NET AMOUNT
PAYABLE
DISCOUNT
TOTALS
DETACH BEFORE DEPOSITING
55-537
212
EST. 1878
FREDERICKS FUEL & Heating Service
517 ROUTE 284, WANTAGE, NJ 07461
P.O. BOX 308 , UNIONVILLE, NY 10988
BLOOMINGDALE OFFICE
BLOOMINGDALE, N.J.
VENDOR NUMBER
(973) 875-4200
(845) 726-3326
CHECK
NUMBER
DATE
DOLLARS
CENTS
$
PAY
TO THE
ORDER
OF
DRM Inc.
ADD SYSTEMS
CNC, STS, AWE
& MANY MORE
ECK
R CH
LASE
Available in:
Single or multi-ply on MICR Bond
Safety Paper or NCR.
ALL COLORS
MICR encoded per bank specs.
1 to 2 weeks delivery.
A/P
K
CHEC
THIS CHECK IS PRINTED WITH A BLUE BACKGROUND “VOID” PANTOGRAPH FEATURE AND MICROPRINT SIGNATURE LINE.
SAUDER FUEL, INC.
002000
BLUE BALL
NATIONAL BANK
590 BLACK HORSE ROAD
REINHOLDS, PA 17569
(717) 484-0900
BLUE BALL, PENNSYLVANIA 17506
80-1091
313
K.W. RASTALL OIL COMPANY
$
PAY TO THE
ORDER OF
DATE
INVOICE #
• 2600 RT. 130 • P.O. BOX 7174 • NORTH BRUNSWICK, NJ 08902
DESCRIPTION
GROSS AMOUNT
DEDUCTION
NET AMOUNT
DOLLARS
MEMO
A/P
K
CHEC
002000
A/P
K
CHEC
002000
Central Oil Company • 9 CANAL STREET • CHICOPEE, MASSACHUSETTS 01013
NT
ME D
Y
PA C O R
RE
DATE
INVOICE #
DESCRIPTION
GROSS AMOUNT
CHECK DATE
DEDUCTION
CHECK NUMBER
TOTAL
NET AMOUNT
SUMMIT BANK
2600 RT. 130 • P.O. BOX 7174
NORTH BRUNSWICK, NJ 08902-2600
(732) 297-5600
DATE
AUTHORIZED SIGNATURE
EMP. #
EMPLOYEE NAME
HOL HOURS/HOL $
VAC HOURS/VAC $
GROSS/GROSS YTD FED WITH/FED YTD FICA WITH/FICA YTD
NYS WITH/NYS YTD
REG HOURS/REG $
OT HOURS/OT $
в—Џ
53-248
118
THE BANK OF WESTERN MASSACHUSETTS
SPRINGFIELD, MASSACHUSETTS
CHKOFF/CHKOFF YTD
PAY THIS AMOUNT
в—Џ
в—Џ
AUTHORIZED SIGNATURE
000001
в– |
:123456789 :
||
в—Џ
в—Џ
00 123456
||
WARMTH & SECURITY SINCE 1891
в– в—Џ
DATE
WARMTH & SECURITY SINCE 1891
EMP. #
WARMTH & SECURITY SINCE 1891
WEHOF FORMS • 800-221-1209
CHECK NO.
в—Џ
||
в—Џ
BONUS
SICK HRS/SICK $
WARMTH & SECURITY SINCE 1891
PAY
WARMTH & SECURITY SINCE 1891
TO THE
ORDER
OF
WARMTH & SECURITY SINCE 1891
50-943
213
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
OLL
PAYR K
W. R. M HE’C
S
,I
C
WARMTH & SECURITY SINCE 1891
J.P. MORGAN CHASE BANK
6040 TARBELL ROAD
WARMTH & SECURITY SINCE 1891
SYRACUSE,
NY 13206
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
в—Џ
www.FormsPro.net
DIS/DIS YTD
в—Џ
в—Џ
MED DED/MED YTD
в—Џ
в—Џ
PAY
TO THE
ORDER
OF
в– в—Џ
NET PAY
в—Џ
в—Џ
The Purple People Heaters.
||
016850
в—Џ
в—Џ
DATE
O.T. RATE
в—Џ
в—Џ
TOTAL
9 CANAL STREET
CHICOPEE, MASSACHUSETTS 01013
REG. RATE
в—Џ
A/P
K
CHEC
Central Oil Company
PAY THIS AMOUNT
W. R. MARRAN’S SONS, INC.
20 CORPORATE DRIVE • HOLTSVILLE, N.Y. 11742
PAY PER ENDING
CHECK NUMBER
CHECK NO.
PAY
TO THE
ORDER
OF
в—Џ
CHECK DATE
55-208
312
LIBERTY MALL OFFICE
K.W. RASTALL OIL COMPANY
016850
WARMTH & SECURITY SINCE 1891
ARRAN S
ONS NC.
WARMTH & SECURITY SINCE 1891
PAYROLL ACCOUNT
WARMTH & SECURITY SINCE 1891
20 CORPORATE DRIVE
HOLTSVILLE, N.Y. 11742
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
021309434
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
755506154
в—Џ
в—Џ
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
016850
CHECK NO.
DOLLARS
WARMTH & SECURITY SINCE 1891
CENTS
WARMTH & SECURITY SINCE 1891
в—Џ
в—Џ
W. R. MARRAN
’S S&ONS
, ISINCE
NC.1891
WARMTH
SECURITY
WARMTH & SECURITY SINCE 1891
в—Џ
в—Џ
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
в—Џ
в—Џ
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
WARMTH & SECURITY SINCE 1891
в—Џ
в—Џ
14
CUSTOM PRODUCTS
POST CARDS
please call for
your annual
oil burner
tune-up.
just a
reminder …
•
•
•
•
fuel oil
24 hr. burner service
installation
budget plans
Montella Oil Company
401.861.4107
MONTELLA OIL - POST CARD.indd 1
8/6/10 10:50:12 AM
Cus tom Pos t Cards prov ide an
ef fe ct i ve and e asy me thod
for ale rt ing your cus tome rs
to spe cial product of fe r ings,
ne w se r v ice s or the nee d to
sche dule mainte nance .
962 SOUTHAMPTON ROAD
WESTFIELD MA 01085
IT’S TUNE-UP TIME
FUEL SERVICES-PC-TUNE UP.indd 2
12/23/09 9:31:21 AM
413-562-0650 or 413-532-3500
FUEL SERVICES-PC-TUNE UP.indd 1
12/23/09 9:31:21 AM
Matching Letterhead, Business
Cards, Envelopes & Folder
STATIONARY
PRESENTATION FOLDER
FRONT
Our letterheads, business cards and envelopes are
printed on laser compatible, acid-free paper with long
grain for trouble-free running on laser printers. Heat
resistant inks to ensure smudge-free printing.
609.646.5560 • fax 609.272.1014
ERN
MOD
GAS
VILLE
SANT
PLEA
0427
32427
NJ 082
BOX
LLE,
P.O.
ANTVI
PLEAS
dd 1
#10 env.in
Call one of our Modern Gas locations today!
rd.
track
16 Old 7647
p.O. bOx h, ct 06836-7647
[email protected]
susannah.bu
greenwic
EMAIL:
21-2323
PH: 203-2 21-2320
FAX: 203-2
ervices.com
в�… Price Protection Options
19 PM
Office Mana
в�… 24/7 Emergency Service
1:16:
в�… Automatic Propane Delivery
/08
11/26
Service You Can Count On
ds
John Fielger
Quality Equipment & Appliances
в�… High-Efficiency Systems
в�… Fuel Conversions
в�… Aboveground & Underground
Tank Installations
в�… Tank Monitoring Program
Sales and Service
55 OLD FIELD POINT rD.
P.O. bOx 7647
grEENwIch, cT 06830
OFFICE: 203-869-4226
FAX: 203-869-4227
MODErN
gAS bc
- rAYMOND.indd
5 NJ 08234 • P.O. Box 427,
7/30/10 Pleasantville,
9:29:07 AM
6645 Delilah Road,
Egg
Harbor
Twsp.
NJ 08232-0427
WOODBINE, NJ: 1480 DeHirsch Avenue • 609-861-2169
BRIDGETON, NJ: 1725 S. Burlington Road • 856-455-1100
PLEASANTVILLE, NJ: 6645 Delilah Road • 609-646-5560
PRESENTATION FOLDER - INSIDE
TO ORDER CALL
800-221-1209
CUSTOM PRODUCTS
15
ENVELOPES
#63вЃ„4 ENVELOPES
THE OIL MAN, INC.
1727 MAUCH CHUNK ROAD
ALLENTOWN PA,18104
#63вЃ„4 REGULAR
THE OIL MAN, INC.
1727 MAUCH CHUNK ROAD
ALLENTOWN PA,18104
#63вЃ„4 WINDOW
1727 MAUCH CHUNK ROAD
ALLENTOWN PA 18104
#63вЃ„4 RETURN
•
•
•
•
•
#7 ENVELOPES
All Sizes and Colors Available
Printed Front, Back or Both Sides
Competitive Prices
Includes All Set-Up Charges
Available in Recycled Stocks
P.O. BOX 604
KEENE, NEW HAMPSHIRE 03431-0604
#7 REGULAR
P.O. BOX 604
KEENE, NEW HAMPSHIRE 03431-0604
#7 WINDOW
#9 ENVELOPE
PLACE
STAMP
HERE
OIL
#9 RETURN
401 Walcott Street
P.O. Box 1670
Pawtucket, RI 02862
DUPUIS #9 RETURN ENV.indd 1
#9 & #10 ENVELOPES
222 KINGS HIGHWAY CUTOFF • FAIRFIELD, CT. 06824
222 KINGS HIGHWAY CUTOFF • FAIRFIELD, CT. 06824
7/14/09 2:53:30 PM
Call for Cur re nt Pr ice s
and Save Time and Money
on Your Ne xt Purchase!
1 to 2 Wee k s
Standard De li ver y.
#9 or #10 REGULAR
#9 or #10 WINDOW
www.FormsPro.net
16
SUPPLIES
GLOVES
TOP QUALITY
NATIONAL BRAND PRODUCTS AVAILABLE IN LARGE
SIZE ONLY.
DRIVER’S CHOICE FOR WINTER COMFORT
MONKEY GRIPв„ў*
1 Dozen
$ 10.50/pair $ 126.00/ctn.
2 Dozen
$ 10.00/pair $ 240.00/ctn.
4 Dozen
$ 9.75/pair $ 468.00/ctn.
6 Dozen
$ 9.50/pair $ 684.00/ctn.
Available in Rough (23-173) or Smooth (23-193) Finish.
Ansell
Edmont
*Edmont and
Monkey Grip
are trademarks
of the Becton,
Dickinson and
Company.
ECONOMICAL WINTER COMFORT
ECONO GRIP
1 Dozen
2 Dozen
4 Dozen
6 Dozen
$ 5.75/pair
$ 5.25/pair
$ 5.00/pair
$ 4.75/pair
$ 69.00/ctn.
$ 126.00/ctn.
$ 240.00/ctn.
$ 342.00/ctn.
These PVC gloves are liquid and chemical resistant and
have a flannel lining that keeps hands nicely warmed
throughout the workday.
ECONOMY LINE
PVC GLOVES
1 Dozen
2 Dozen
4 Dozen
6 Dozen
$ 3.50/pair
$ 3.25/pair
$ 3.00/pair
$ 2.90/pair
ARE
COMP E!
& SAV
$ 42.00/ctn.
$ 78.00/ctn.
$ 144.00/ctn.
$ 208.80/ctn.
These PVC gloves are liquid and chemical resistant
and have a cotton lining that keeps hands comfortable
throughout the workday.
TO ORDER CALL
800-221-1209
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE
SUPPLIES
FORMS
17
FILL PIPE TAGS / I.D. LABELS
FILL PIPE LABELS
Avoid delivery errors by identifying your
customer’s fill pipe with a 2” X 3” label. White
vinyl, permanent adhesive, printed in one or two
colors with laminated finish. Great for outdoor
use.
1 COLOR
500 Labels $ 115.00
1000 Labels $ 145.00
2000 Labels $ 255.00
3000 Labels $ 340.00
BOBКјS OIL
24-HR SERVICE
722-1001
BOBКјS OIL
2 COLOR
$ 170.00
$ 210.00
$ 350.00
$ 440.00
24-HR SERVICE
BOBКјS OIL
24-HR SERVICE
FILL CAP/THERMOSTAT LABELS
Display your corporate image every day on these
striking fill cap and thermostat labels - made of
high quality, pressure sensitive vinyl. Size: 1” round.
Great for outdoor use.
1 COLOR
500 Labels $ 100.00
1000 Labels $ 130.00
2000 Labels $ 220.00
3000 Labels $ 305.00
5000 Labels $ 365.00
653-5050
1-800-262-6462
2 COLOR
$ 160.00
$ 195.00
$ 305.00
$ 380.00
$ 440.00
NEW
FILL PIPE TAGS - Pr inte d wi th your
name and logo!
Display your corporate image and identify your proper
fill pipes every day on these striking fill pipe zip tags made of high quality resins and molded to create a zip
tie for fill pipes. No More Delivering Oil To The Wrong
Tank!! Available in many colors;
STAMP PRINTED for block lettering only.
STAMP ROLLER
PRINTED
PRINTED
500 Tags
$ .60 ea.
$ .65 ea.
1000 Tags
$ .45 ea
$ .50 ea.
2000 Tags
$ .39 ea.
$ .44 ea.
3000 Tags
$ .35 ea. $ .39 ea.
5000 Labels $ .31 ea.
$ .35 ea.
Bar coding also available
for an addi t ional cos t.
STAMP PRINTING
& NUMBERING
ROLLER
PRINTING
W / LOGO
www.FormsPro.net
www.FormsPro.net
ROLLER PRINTING
W / BAR CODING
SUPPLIES
We make all s t yle s of labe ls: die cu t, laminate d,
v inyl, cont inuous fee d, 4 color, and many more!
LABELS
BOILER LABELS - STOCK 6” X 4”
500 Labels
1000 Labels
2000 Labels
3000 Labels
5000 Labels
Permanent Adhesive •
REPAIR LABELS
  $ 100.00/lot
$ 120.00/lot
$ 215.00/lot
$ 290.00/lot
$ 425.00/lot
Any Standard Color
IF THE OIL BURNER FAILS TO OPERATE:
1.
2.
3.
4.
5.
6.
BE SURE THAT THE OIL BURNER SWITCH IS ON.
THERMOSTAT SHOULD BE SET ABOVE ROOM TEMPERATURE.
MAKE SURE THAT THERE IS OIL IN THE TANK.
PRESS RESET BUTTON ONCE ONLY!
CHECK TO SEE IF FLAME COMES ON.
IF BURNER DOES NOT RUN AT ALL, CHECK FOR BLOWN OR LOOSE FUSE.
IF BURNER FAILS TO OPERATE - CALL FOR SERVICE
BUY-RITE FUEL
1223 Lincoln Terrace, Peekskill, NY 10566
914-737-2200
BUY RITE FUEL - Boiler Label.indd 1
5/10/10 11:29:41 AM
Records repairs for future visits to prevent wasting
time troubleshooting problems.
CUSTOM IDENTIFICATION
LABELS
High quality ID Labels put your Company’s name and
image in front of your customers’ eyes. Customize and
use your Company logo.
H Call for a Price Quote and Samples.
STOCK COMPUTER PAPER
BEND & PEEL THIS STRIP FIRST
18
CALL FOR SERVICE: 800-562-2777
MORRIS
973-285-1144
UNION
MARLBORO
732-462-5999
BERGEN
908-688-1111
201-567-1131
LASER BOND
81⁄2” X 11”
Laser Compatible Bond w/Perf.
Available in 20# or 24# Laser Bond
R
LASE
BOND
Form #S38
20# w/micro perf - $ 17.00/M
Form #S39
24# w/micro perf - $ 18.00/M
2 OR 3 PLY CARBONLESS
LASER SHEETS also available
REGISTER FORMS
phone: (336) 882-3366
1219 W. Ward Ave. • P.O. Box 7024
High Point, NC 27264
N.C. License 2992
CUSTOMER’S ORDER NO.
PHONE
DATE
NAME
ADDRESS
Custom printed register
forms, printed on NCR
or Register Bond stock.
Free set-up & design
with your order!
TO ORDER CALL
QTY.
DESCRIPTION
PRICE
AMOUNT
COM
PA
& SA RE
VE!
TAX
RECEIVED BY
34000
800-221-1209
TOTAL
Thank You.
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE
SUPPLIES
FORMS
19
PROMOTIONAL PRODUCTS
CALENDARS
13 Month Calendar
Size: 10 1/2” x 18 1/4” opened
Give us a call and we’ll
email you a flyer that shows
our full line of calendars.
You’ll be sure to find one
that fits your needs.
2015
5
201
YOUR COMP
ANY NAME
& LOGO HERE
.
YOUR COMPANY NAME
& LOGO HERE.
January 2015
E
Y NAM
OMPAN
YOUR C GO HERE.
& LO
ANY NAME
YOUR COMP
.
& LOGO HERE
YOUR COMPANY NAME
& LOGO HERE.
Orde r Early!
Due to the timing of
calendar orders, pricing
is based on what date
you order. The earlier
you order the less
expensive they are.
The best pricing is
available March through
April. We can place your
order any time!
2015 PRICES
Spiral construction Stapled construction
1 color imprint
1 color imprint
Qty.
100
300
500
   1000
Prices Qty.
$1.60 ea. 100
$1.40 ea. 300
$1.35 ea. 500
$1.30 ea.      
   1000
www.FormsPro.net
www.FormsPro.net
Prices $1.50 ea.
$1.30 ea.
$1.25 ea.
$1.20 ea.
20
SUPPLIES
PROMOTIONAL PRODUCTS - MAGNETS
BUSINESS CARD
Size: 2” x 3.5”, 25 Mil Magnet Stock
Qty.
500 1000 2500
Prices $.24 $.20  $.15
5000
$.11 ea.
LARGE PROPANE TANK
Size: 5” x 2.25”, 25 Mil Magnet Stock
Qty.
500
1000
2500
5000
Prices
$.56 ea.
$.35 ea.
$.20 ea.
$.18 ea.
yo u r
e
s
i
t
r
e
Ad v
e!
m
a
n
y
n
C omp a
SMALL PROPANE TANK
Size: 2.25” x 3.3”, 25 Mil Magnet Stock
Qty.
500
1000
2500
5000
Prices
$.40 ea.
$.24 ea.
$.16 ea.
$.12 ea.
BOBTAIL TRUCK
OIL TRUCK
1-888-740-4328
207-268-4328
Propane Services Inc.
28 W. Dewey • Butte, MT 59702
BUS. (406) 494-4333
(1-800) 823-4931
Locally Owned and Operated
Litchfield, ME
Size: 3.7” x 1.6”, 25 Mil Magnet Stock
Qty.  500
Prices $.37
1000 2500
$.22  $.15
TO ORDER CALL
5000
$.11 ea.
800-221-1209
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE
SUPPLIES
FORMS
PROMOTIONAL PRODUCTS
GIVEAWAYS
This is a sampling of the new promotional items we now have available for
you to: promote your company image, say “Thank You” to your
customers, or mark an anniversary. Please call for a full catalog!
RAZOR THIN-FLASHLIGHT
Available in 4 colors
($40.00 set-up charge)
Qty.
250
500
1000
2500
Prices
$1.00 ea.
$ .95 ea.
$ .90 ea.
$ .85 ea.
STRESS BALLS
PAPER MATE PEN
Available in 5 colors
Qty.
300
500
1000
2500
Qty.
100
250
500
1000
2500
Available in 9 colors
Prices
$.70 ea.
$.65 ea.
$.60 ea.
$.55 ea.
($40.00 set-up charge)
Prices
$1.15 ea.
$1.05 ea.
$1.00 ea.
$ .90 ea.
$ .85 ea.
#1 KEY CHAIN
Available in 9 colors
($45.00 set-up charge)
Qty.
500
1000
2500
ICE SCRAPERS
Available in 4 colors
($40.00 set-up charge)
Qty.
150
250
500
1000
Prices
$1.95 ea.
$1.85 ea.
$1.80 ea.
$1.65 ea.
Prices
$.45 ea.
$.42 ea.
$.38 ea.
CHIP CLIPS
Available in 6 colors
($40.00 set-up charge)
Qty.
200
500
1000
2500
www.FormsPro.net
www.FormsPro.net
Prices
$1.25 ea.
$1.20 ea.
$1.10 ea.
$ .95 ea.
21
22
ELECTRONIC METER TICKETS
CUSTOM ELECTRONIC METER TICKETS
We are experts in designing and integrating electronic register
forms into your operations. These forms can be designed with or
without return envelopes.
NCR stock, carbon interleaved plys or roll products, we know how
to make your forms perform, so you can get the most from your
technology investment.
Continuous, individual or rolls – we have the capability to design the
most comprehensive tickets for new - state of the art electronic
registers, cab-mounted or handheld. Let us put our knowledge to
work for you!
PLACE
STAMP
HERE
Safety Notice
REORDER FROM WEHOF FORMS (800) 221-1209
PROPANE INVOICE
PROPERTIES OF PROPANE GAS:
• Propane is a flammable gas that can cause fires and explosions.
• Propane is heavier than air and can collect in low places (along
the floor, in basements, etc.)
• Propane has been odorized so you can smell it.
W 01001
IF YOU DETECT AN ODOR:
• Open windows and doors to increase ventilation.
• DO NOT light matches or cigarettes.
• DO NOT operate switches, electrical appliances, thermostats or
telephones. They may cause a spark to ignite escaping gas.
• Check to be sure all pilots are burning.
• If the source has not been detected, get everyone out of the
building and shut off the propane supply at the container.
• Call us from a neighbor’s phone. DO NOT go back in the building.
1480 DeHIRSCH AVENUE • P.O. BOX 455
WOODBINE, NJ 08270
TEL: (609) 861-2169 • TOLL FREE: (800) 624-1228
PO BOX 5490
WAKEFIELD RI 02880-5490
REMEMBER THIS ABOUT PROPANE’S ODOR:
• Some people are unable to detect the odorant in gas.
• Colds, allergies and sinus congestion can all affect your sense of
smell.
• Tobacco smoke or strong cooking odors can cover up other odors.
• The use of tobacco, alcohol or drugs may also affect your sense of
smell.
IF YOU RUN OUT OF GAS:
• Shut off the main supply valve at your tank(s). Learn where this
supply shut off valve is located by asking us.
• Shut off all appliance burners and pilot valves. Instructions should be
on or with the appliance.
• When gas service is restored, to avoid hazards, have us turn the
valves back on, light the pilots and check the controls.
• Be sure all appliances are checked.
METER TICKET W/ENVELOPE
GALLONS DEL.
PRICE / GALLON
TOTAL DUE
REMEMBER:
• NEVER tamper with your appliance and related equipment. All
repairs must be done by our qualified service technicians.
• If appliance control has been exposed to water — it must be
replaced by our service technician immediately.
• All gas appliances must be installed by qualified service technicians.
• DO NOT remove gas appliances, as all open gas lines must be
plugged, capped or removed completely.
AMOUNT DUE WITHIN 7 DAYS
WEHOF FORMS 1(800) 221-1209
HEATING OIL/DYED DIESEL FUEL, NON-TAXABLE USE ONLY; PENALTY FOR TAXABLE USE.
D D NEXT
TANK SIZE
LAST DELIVERY
CURR. K
FILL LOCATION
PREVIOUS BALANCE
ACCOUNT NO.
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO
PROPANE APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
RUNOUT
How to Close Gas Supply Valves
VALIANT OIL COMPANY
235 WESTON STREET
WALTHAM, MA 02453
(781) 891-1000 • (617) 965-1000
CUSTOMER SIGNATURE
TERMS: NET 15 DAYS. A SERVICE CHARGE OF 13вЃ„4% PER MONTH (21% PER YEAR) WILL BE CHARGED
ON UNPAID BALANCES OVER 30 DAYS. SERVICE CHARGE WILL APPLY ON SPECIAL DELIVERIES.
0001
VOLUME DELIVERED HAS BEEN COMPENSATED TO VOLUME AT 60ВєF.
PRODUCT DELIVERED: PROPANE LPG
CUSTOMER COPY
METER TICKET
METER TICKET W/BACKER
METER TICKET
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C h rease y impo a in co fed er h e
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inc
comp undesocia te e r n i g anu s
help as al, sta g o v nd lina r d o
costs loc i o n s fe ha h a z
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tra t r i b .
d i s terials
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TU
RN
ROLL TICKET
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TO ORDER CALL
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We are your source for F-RAMS Meter
Systems forms. We have many years of
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Let us help you get the most from your
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SAFETY NOTICE
For your safety, propane has an odor added so you can detect leaks. You and each person
using or handling propane of your household must know the smell of propane. Ask for a scratch
�n sniff brochure or MSDS to demonstrate the odor. If anyone is unable to recognize the odor of
propane, call us immediately.
Propane is heavier than air; therefore, leaks will tend to settle to floor or ground levels. To check
for propane, carefully smell in low spots.
Under some of the following conditions, you may not be able to smell a gas leak. For Example:
Age, colds, allergies, sinus congestion or the use of tobacco, alcohol or drugs may
diminish your sense of smell.
Cooking or other strong odors may cover up the smell of gas.
In certain circumstances, propane gas may lose its distinctive smell - this is called
“ODORANT FADE”.
Sometimes propane gas can lose its odor if a leak occurs underground or if there
is rust on the inside of the cylinder or piping.
Some persons are physically unable to detect the smell of gas. If you are one of
these people, call us immediately.
For those reasons, it is recommended that you purchase and install a propane gas detector(s)
according to the manufacturer’s instructions as a back-up warning device. If anyone using or
handling propane is unable to recognize the odor of propane, you should not use it until you
have purchased and installed gas detector(s).
WHAT TO DO IF YOU SMELL GAS...
PLACE
STAMP
HERE
1.
Put out all smoking materials and other open flames.
2.
DO NOT operate a light switch, telephone, cigarette lighter, appliance or thermostat. Any
spark in the area where propane gas is present may ignite the gas.
3.
Get everyone out of the building immediately.
4.
Shut off the gas supply at the tank or cylinder.
(See below)
How To Close Gas Supply Valves
3003 DAWN DRIVE
SUITE 105
GEORGETOWN TX 78628
METER TICKET W/ENVELOPE & BACKER
ZONE
REORDER FROM WEHOF FORMS (800) 221-1209
TYPE
PROD.
ACCOUNT NO.
K. FACTOR
R.O. D.D.
PHONE NO.
CR. LIMIT
TANK SIZE
5.
Call F-RAMS ® - use your neighbor’s telephone if gas odor is in the building.
6.
Have your F-RAMS В® service person locate and repair the leak. Have your F-RAMS В® serice person air out the area and check and re-light your gas appliances. Do not return to
the building until you are advised that all leaks have been repaired and it is safe to return.
D.D. NEXT DELIVERY
RESV
HW
S
O
L
D
T
O
I
N
S
T
R
U
C
T
I
O
N
S
DATE
ACC. D.D.
GALLONS
K. FACTOR
DELIVERY DATE
PAYMENT RECEIVED
REORDER FORM #3EMT FROM WEHOF FORMS 800-221-1209
$
D C
E H
L A
I R
V G
E
R E
Y
ROY BROS. в„ў
OIL & PROPANE
Proud Sponsor of the New England Patriots
O A
U D
T D
I
S T
I I
D V
E E
REMIT PAYMENT TO: P.O. Box 847289 • Boston, MA 02284-7289
PLEASE INCLUDE ACCOUNT NUMBER WITH REMITTANCE
P R
R E
I L
M I
E G
/ H
T
CHECK IF
NOT FULL
ROY BROS. OIL & PROPANE
(800) 558-5280
METER TICKET
FORM #3-EMT METER TICKET
4” X 113⁄4”
3-Ply NCR Stock w/Hard Back Copy
2000/ctn.
    QTY.
PRICE
1 ctn.    2000     $ 180.00
2 ctn.    4000   $ 348.00
3 ctn.    6000
$ 504.00
4 ctn.    8000
$ 648.00
5 ctn. 10000
$ 780.00
T
#3-EM
PRICE
PER 1,000
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
For use in F-RAMS Electronic Register. Use as a delivery
ticket or a calibration ticket. Top quality NCR stock for
superior image transfer.
www.FormsPro.net
DRIVER SIGNATURE
PAYMENT RECEIVED
$
CHECK
IF TANK
NOT FULL
CASH
CHECK
01001
CUSTOMER SIGNATURE
X
23
REO
RDER
FORM
T
#3EM
FROM
FORM
S
800-2
21-12
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FORM # 3-EMTPB
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$
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CHECK
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IF
SIGNA
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For Higher qty pricing call for quote
Custom printing available
TURE
- Meter Ticket, 4”x 11-3/4”
3 ply NCR Stock w/Hard Back
Copy. 2000/ ctn.
R
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REORD
3/2/11
4 PM
2:39:5
For Higher qty pricing call for quote
Custom roll printing available
Thermal Roll Meter Ticket
4-1/4” x 330’ - High Quality Thermal stock
3.4 ml. Roll Tickets. For use in Cognitive
thermal roll printers, 8/Rls/Ctn.
800-221-1209
TO ORDER CALL
WITH TIMING
MARK AND
PERFORATIONS
FORM # TSR4
NEW
TOTAL CONTROL SYSTEMS
$10.40/roll
$ 9.70/roll
$ 9.25/roll
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$ 8.30/roll
$ 7.20/roll
TURN
1 Ctn. 50
$175.00/lot $3.50/roll
5 Ctn. 250 $812.50/lot $3.25/roll
10 Ctn. 500 $1500/lot
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FORM # TCE200
$90.00/m
$87.00/m
$84.00/m
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1 Ctn. 2000 $180.00/lot
2 Ctn. 4000 $348.00/lot
3 Ctn. 6000 $504.00/lot
4 Ctn. 8000 $648.00/lot
5 Ctn. 10000 $780.00/lot
Meter Ticket, 4”x 11-3/4”
3 ply NCR Stock w/Hard Back Copy.
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14-20 Ctn. 112-160 rolls
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25-38 Ctn. 200-304 rolls
39-50 Ctn. 312-400 rolls
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ELECTRONIC METER TICKETS
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roll printers Model TMU 200D - 50/
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FORM # TSR4B
AUTHOR IZED TCS
TICKET SUP P LIER
TSR4
B.ind
d
1
l and
3/2/1
1
PM
FORM # VTR4
54
2:39:
1-4 Ctn.
5-8 Ctn.
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13-16 Ctn.
17-20 Ctn.
25-100
125-200
225-300
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rolls
rolls
rolls
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1-4 Ctn.
5-8 Ctn.
9-12 Ctn.
13-16 Ctn.
17-20 Ctn.
25-100
125-200
225-300
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rolls
rolls
rolls
rolls
rolls
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1-4 Ctn.
5-8 Ctn.
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13-16 Ctn.
17-20 Ctn.
25-100
125-200
225-300
325-400
425-500
rolls
rolls
rolls
rolls
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125-200
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$1.35/roll
$1.30/roll
ty
ified
us listed
ber delive
s
a qual
this
pilot
call the
the
you ht
s to
ons, relig
valve
reas, if you
off
ETY le
E SAF maband
ll
PAN ly flamthingd may
sma
PRO eme brea liquiain
extr for anecont cts.
ON
YOU t
N
an lableProp
defe
can
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is
ly
birth
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ll
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ED
ane
ane en
or
fami erymsme ier
ORM Propoxyg spacProp er R ADD
your deliv ot heav and
:
nedbite. e canc
INF
of or
l
ODOber an d cannis leve
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ANT TEMr redu in confi
ane
AN
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Propat floor
ORT STAvapo n ar n
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ll
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TSR4
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54
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chem
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gas. caus
anyo us l. Care
ETYKS ane.
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nt. tank
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may e tities
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if gas
or
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quan YOU ECT ll its
eany hes equi
lls ct at prop
sme
valve phon
LL
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’s
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onstor will
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has
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ane, and s to
neig
leak
to
IF
the
king applandusin
prop air spot DO
your
es
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thanlow
smo any ide ly,
r
- use off until
SE
in
all ate outssupp
Valv
T TO
lier
CLO ES: and/onot
out oper
ply
gas
WHA Put not yone gas
supp
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e. e the
am, num-of
1. Do ever the
LY unsu
ane
HOW
are llation
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diagr
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you insta this hone front
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the and
se
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.
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Do not wet
S
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,
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b. Do
light the n
d
indicpilot
FORM
c. Have edia
s. pilot ilate nicia turer d
F
the
d. imm rstan
odor
ufac coulht
WEHO
Unde g lightly vent tech ges
e. stron not
ifiednt man to relig B FROM
outapt
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f. com a pmepilot
# TSR4
Call equi d attem FORM
g. the eate not
DER
Rep. Do
h. . .
REOR
leve
TS. safe ever shutLL
floor
ual
SME
at .
PILO for How
R that s.
man
anepilot YOU
.
ing.
IF
and
LTYOU nd pilot
the
valveof prop
G mmeyour
light
ols
ht TO DO
E BUI:
-off
TIN reco ht
pilot
contr
relig AT
shut ence
to
for
HAV king ane
IGH gly to relig ance
pres
“WH
ns
tankthe ptingSee
CES wor prop
REL stron n
appli
uctio
We nicia
all ion. thell for attem P LIANthemice your
instr
tech self:
positopen
’s
sme re - STO
youra. Turn
APP
es.
OFF ly
befoted
keepto serv
turer
iced
other
Slow fully s
ianc
ANDhelp l
by
serv
sb. Care spotis detece. ufac
up
TEM . .to onne on applane. rols
c. low
abov man
red
. d pers
g odor w
If gas ” the
cove
rols of prop cont
E SYS ESalifie
d. GAS w
stron
follo
be
cont out es and
Follo
or
PAN TUR
e.
are
ition
fully
unqu
fade
ianc gasm run ianc
an.
PRO FEA
care
there
s cond
R ETY allowappl with
can
re
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er systeed appl
s or
rdouserv
YOU SAF not m or
odor
209
pilot ns.
s whe
your
ane
ht uctio a haza
IN a. Dosystenot tamp
221-1
let or flood
your
area first.
e.
WITH TIMING MARK AND PERFORATIONS
CK
N
Blank Thermal Roll Meter Ticket 4 ” x 80’ 3/4”
core - Thermal stock 3.4 ml. Roll Tickets For use
in Zebra thermal roll printers, 8.5” repeat perfed.
Model RW420 - 25/Rls/Ctn.
BA
TUR
CK
Thermal Roll Meter Ticket
4 ” x 80’ 3/4” core - Thermal stock 3.4 ml. Roll
Tickets with Duty to warn Backer. For use in Zebra
thermal roll printers, Model RW420 - 25/Rls/Ctn.
Blank Thermal Roll Meter Ticket 4 ” x 125’ 3/4” core
- Thermal stock 2.4 ml. Roll Tickets For use in Zebra
thermal roll printers, Model RW420 - 25/Rls/Ctn.
FORM # CRP3
Blank Thermal Roll Meter Ticket 3-1/8 ” x 125’
1/2” core - Thermal stock 2.4ml. -Roll Tickets For
use in Citizen thermal roll printers, Model CMP30 - 25/Rls/Ctn.
FORM # PRP4
Blank Thermal Roll Meter Ticket 4 ” x 85’ 3/4”
core - Thermal stock 2.4ml. - Roll Tickets For use
in Printek thermal roll printers,
Model - Field Pro Series - 25/Rls/Ctn.
www.FormsPro.net
$5.25/roll
$4.50/roll
$3.75/roll
$3.25/roll
$2.90/roll
rolls
rolls
rolls
rolls
rolls
25-100
125-200
225-300
325-400
425-500
1-4 Ctn.
5-8 Ctn.
9-12 Ctn.
13-16 Ctn.
17-20 Ctn.
Thermal Roll Meter Ticket
4 ” x 80’ 3/4” core - Thermal stock 3.4 ml. Roll
Tickets with Duty to warn Backer. For use in
Zebra thermal roll printers, 8.5” repeat perfed
- 25/Rls/Ctn.
BA
25
TOTAL CONTROL SYSTEMS
TCOTAL
ONTROL
SYSTEMS
ELECTRONIC METER TICKETS
Zebra Roll Printer
Model RW 420
FORM # VTR4B
Citizen Roll Printer
Model CMP-30
Printek Roll Printer
Model Field Pro Series
ELECTRONIC METER TICKETS
LIQUID CONTROL TICKETS
BACKER FOR LC-3PB & #3-EMTPB
K
STOC
FORM
PB
#LC-3
REORDER FORM #3EMT FROM WEHOF FORMS 800-221-1209
K
STOC
FORM
T
#3-EM
&
TPB
#3-EM
Safety Notice
PROPERTIES OF PROPANE GAS:
• Propaneisaflammablegasthatcancausefiresandexplosions.
• Propaneisheavierthanairandcancollectinlowplaces(along
thefloor,inbasements,etc.)
• Propanehasbeenodorizedsoyoucansmellit.
IF YOU DETECT AN ODOR:
•
•
•
•
•
•
Openwindowsanddoorstoincreaseventilation.
DONOTlightmatchesorcigarettes.
DONOToperateswitches,electricalappliances,thermostatsor
telephones.Theymaycauseasparktoigniteescapinggas.
Checktobesureallpilotsareburning.
Ifthesourcehasnotbeendetected,geteveryoneoutofthe
buildingandshutoffthepropanesupplyatthecontainer.
Callusfromaneighbor’sphone.DONOTgobackinthebuilding.
REMEMBER THIS ABOUT PROPANE’S ODOR:
• Somepeopleareunabletodetecttheodorantingas.
• Colds,allergiesandsinuscongestioncanallaffectyoursenseof
smell.
• Tobaccosmokeorstrongcookingodorscancoverupotherodors.
• Theuseoftobacco,alcoholordrugsmayalsoaffectyoursenseof
smell.
IF YOU RUN OUT OF GAS:
• Shutoffthemainsupplyvalveatyourtank(s).Learnwherethissupply
shutoffvalveislocatedbyaskingus.
• Shutoffallapplianceburnersandpilotvalves.Instructionsshouldbe
onorwiththeappliance.
• Whengasserviceisrestored,toavoidhazards,haveusturnthe
valvesbackon,lightthepilotsandcheckthecontrols.
• Besureallappliancesarechecked.
REMEMBER:
•
•
•
•
NEVERtamperwithyourapplianceandrelatedequipment.All
repairsmustbedonebyourqualifiedservicetechnicians.
Ifappliancecontrolhasbeenexposedtowater—itmustbe
replacedbyourservicetechnicianimmediately.
Allgasappliancesmustbeinstalledbyqualifiedservicetechnicians.
DONOTremovegasappliances,asallopengaslinesmustbe
plugged,cappedorremovedcompletely.
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO
PROPANE APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
How to Close Gas Supply Valves
Shut off
valve here
Shut off
valve here
Shut off
valve here
DRIVER SIGNATURE
PAYMENT RECEIVED
$
CHECK
IF TANK
NOT FULL
01001
CUSTOMER SIGNATURE
CASH
CHECK X
REORDER FORM LC-9PB FROM WEHOF FORMS (800) 221-1209
K
STOC
FORM
PB
#LC-9
Safety Notice
PROPERTIES OF PROPANE GAS:
• Propane is a flammable gas that can cause fires and explosions.
• Propane is heavier than air and can collect in low places (along
the floor, in basements, etc.).
• Propane has been odorized so you can smell it.
IF YOU DETECT AN ODOR:
• Open windows and doors to increase ventilation.
• DO NOT light matches or cigarettes.
• DO NOT operate switches, electrical appliances, thermostats or
telephones. They may cause a spark to ignite escaping gas.
• Check to be sure all pilots are burning.
• If the source has not been detected, get everyone out of the
building and shut off the propane supply at the container.
• Call us from a neighbor’s phone. DO NOT go back in the building.
REMEMBER THIS ABOUT PROPANE’S ODOR:
• Some people are unable to detect the odorant in gas.
• Colds, allergies and sinus congestion can all affect your sense of
smell.
• Tobacco smoke or strong cooking odors can cover up other odors.
• The use of tobacco, alcohol or drugs may also affect your sense of
smell.
IF YOU RUN OUT OF GAS:
• Shut off the main supply valve at your tank(s). Learn where this
supply shut off valve is located by asking us.
• Shut off all appliance burners and pilot valves. Instructions should be
on or with the appliance.
• When gas service is restored, to avoid hazards, have us turn the
valves back on, light the pilots and check the controls.
• Be sure all appliances are checked.
REMEMBER:
• NEVER tamper with your appliance and related equipment. All
repairs must be done by our qualified service technicians.
• If appliance control has been exposed to water — it must be
replaced by our service technician immediately.
• All gas appliances must be installed by qualified service technicians.
• DO NOT remove gas appliances, as all open gas lines must be
plugged, capped or removed completely.
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO
PROPANE APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
How to Close Gas Supply Valves
FORM #LC-3PB METER
TICKET & FORM #3-EMTPB
Both forms are 4” X 113⁄4” 3-Ply NCR Stock
w/Hard Back Copy; forms include a “Duty
to Warn” backer for the propane industry;
2000/carton.
PRICE
   QTY.
1 ctn.    2000
2 ctn.  4000
3 ctn. 6000
4 ctn. 8000
5 ctn. 10000
PRICE
PER 1,000
   $ 180.00
   $ 348.00
$ 504.00
$ 648.00
$ 780.00
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
FORM #LC-9PB METER
TICKET
4” X 91⁄2”; 3-Ply NCR Stock w/Hard Back
Copy; includes a “Duty to Warn” backer
for the propane industry; 2000/carton.
   
   QTY.
PRICE
1 ctn.    2000   $ 162.00
2 ctn.  4000
$ 316.00
3 ctn. 6000
$ 462.00
4 ctn. 8000
$ 592.00
5 ctn. 10000
$ 720.00
PRICE
PER 1,000
$ 81.00
$ 79.00
$ 77.00
$ 74.00
$ 72.00
FORM #DD3 & #DD3B THERMAL ROLL TICKET
Both forms are 31⁄8”Wide, 170ft., 5⁄8” core, #DD3 Thermal Roll Stock forms includes
an “Oil Fill Pipe Disclaimer” backer, #DD3B Thermal Roll Stock forms includes
a “Duty to Warn” backer for the propane industry.
25/carton.
RE-ORDER FORM # VTR4B AVAILABLE FROM WEHOF FORMS
26
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
800-221-1209
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
Shut-off
valve here
TO ORDER CALL
Shut-off
valve here
EPSON PRINTER MODEL-TM T88V
How To Close Gas Supply Valves
$ 81.25/box
TURN
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
$ 3.25
K
STOC
M
R
O
F
B
#DD3
RELIGHTING YOUR PILOTS.
$ 90.00/box    
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
10+ boxes
$ 3.60
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
QTY.
1-5 boxes
6-9 boxes
PRICE
  PRICE
PER ROLL
PER BOX
$ 4.00
  $100.00/box    
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
K
STOC
M
R
FO
#DD3
NEW
ELECTRONIC METER TICKETS
REORDER FORM #LC-3C FROM WEHOF FORMS 800-221-1209 www.formspro.net
FORM #LC-3C
41/8” X 11”; 3-Ply w/Carbons and Hard
Back Copy 2000/ctn.
  QTY.
PRICE
1 ctn.    2000    $ 180.00
2 ctn.  4000    $ 348.00
3 ctn. 6000
$ 504.00
4 ctn. 8000
$ 648.00
5 ctn. 10000
$ 780.00
  PRICE
PER 1,000
K
STOC
FORM
3C
#LC-
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
For use in LC Meters. Use as a delivery ticket or a calibration
ticket. Top quality for superior image transfer.
FORM #ST-2 SHIFT REPORT TICKET
REORDER FORM ST-2 FROM WEHOF FORMS (800) 221-1209 www.formspro.net
4 /4” X 11 /4” 2-Ply NCR stock
w/hard back copy.
2000/ctn
1
3
PRICE
  PRICE
PER 1,000
1 ctn.   2000
2 ctn.  4000
3 ctn. 6000
4 ctn. 8000
5 ctn. 10,000
   $ 132.00
  $ 252.00
$ 360.00
$ 456.00
$ 550.00
$ 66.00
$ 63.00
$ 60.00
$ 57.00
$ 55.00
 
QTY.
K
STOC
M
R
FO
2
#ST-
FORM #LCE200
3” X 75’; 2-Ply Carbonless Roll Tickets with “Duty to Warn” Backer.
Suitable for use with Liquid Controls’ Metering Systems and Epson
EPSON Printer Model #TMU200D.
QTY.
PRICE
PER ROLL
 PRICE
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
PER LOT
1 ctn.   $ 3.50 $ 175.00/Lot    
5 ctn.   $ 3.25 $ 812.50/Lot 
10+ ctn.  $ 3.00 $1,500.00/Lot
*50 Rolls/ctn.
BACKER
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
How To Close Gas Supply Valves
TURN
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
  
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
200
#LCE
REORDER FORM # TSR4B FROM WEHOF FORMS (800) 221-1209
TSR4B.indd 1
www.FormsPro.net
3/2/11 2:39:54 PM
27
28
ELECTRONIC METER TICKETS
MID:COM STOCK FORMS
INSERT FACE UP
STOCK MID:COM FORM 8000 &
FORM 6500
INSERT FACE UP
REORDER FORM #MC-8000 FROM WEHOF FORMS 1-800-221-1209
REORDER FORM #MC-6500 FROM WEHOF FORMS 1-800-221-1209
8000
#MC-
6500
#MC-
41⁄4” X 73⁄4” Blank or pre-printed NCR meter
tickets, with hard back copy, designed for
MID:COM systems’ specifications. Both
tickets can be imprinted to include your
company logo, contact information or other
desired
details.
INSERT FACE UP
REORDER FROM WEHOF FORMS 1-800-221-1209
Savage Oil
Think about it!
P.O. BOX 405 • Bingham, ME 04920
PH: 474-1366 • 672-5596
FUEL OIL • KEROSENE • BLEND
DYED UNMARKED HEATING OIL: NOT FOR USE IN
HIGHWAY, NONROAD, LOCOMOTIVE OR MARINE ENGINES.
SOLD TO
ADDRESS
CITY, STATE, ZIP
8000
#MC- ED
T
IN
R
IMP
GALS. READING – START
GALS. READING – FINISH
SALES SEQUENCE NUMBER
PRICE PER GALLON – CENTS
PRODUCT COST
TAX
TOTAL PRICE
вќ‘ CASH
вќ‘ CHECK
PAYMENT REC'D $
вњ—
INVOICE #
“We are the authorized supplier of
1,000
2,000
3,000
4,000
5,000
10,000
01001
SIGNATURE
Blank Stock $ 80.00/M
$ 78.00/M
$ 76.00/M
$ 74.00/M
$ 72.00/M
$ 67.00/M
Imprinted
$ 100.00/M
$ 96.00/M
$ 93.00/M
$ 90.00/M
$ 88.00/M
$ 78.00/M
REORDER FORM #3EMT FROM WEHOF FORMS 800-221-1209
FORM #3-EMT
METER TICKET
4” X 113⁄4”; 3-Ply NCR Stock w/Hard
Back Copy 2000/ctn.
Use as a
delivery ticket
or a calibration
ticket. Top
quality NCR
stock for
superior image
transfer.
  QTY.
PRICE
1 ctn.    2000    $ 180.00
2 ctn.  4000    $ 348.00
3 ctn. 6000
$ 504.00
4 ctn. 8000
$ 648.00
5 ctn. 10000
$ 780.00
T
#3-EM
DRIVER SIGNATURE
CHECK
IF TANK
NOT FULL
01001
CUSTOMER SIGNATURE
CASH
CHECK X
PAYMENT RECEIVED
$
FORM #MC-3
  PRICE
PER 1,000
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
FORM #3-BMT
в—Џ
#3-BMT
TOTAL PRICE
TAX
PRODUCT COST
PRICE PER GALLON - CENTS
SALES SEQUENCE NUMBER
GALS. READING - FINISH
GALS. READING - START
01234
REMOVE THIS STUB FOR MID:COM USE
$
$
IN TANK AFTER
TRUCK #
TAX
TOTAL
$
CASH
CHECK
DRIVER
DATE
в—Џ
GALLONS
$
в—Џ
AMOUNT
3
#MC-
$
в—Џ
DEL. TIME
в—Џ
в—Џ
в—Џ
PRICE
в—Џ
PAYMENT RECEIVED
в—Џ
PRODUCT
REORDER FORM #MC-3 FROM WEHOF FORMS 800-221-1209 FORM MC-3
91⁄2” X 4”; MID:COM/Neptune 91⁄2” X 4” 3-Ply meter ticket NCR stock;
Meter Ticket; 3-Ply with
Pre-numbered with hard back copy; secure
Carbonless Paper; 2000/carton. glue at right side edge; 2000/carton.
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
  QTY.
PRICE
1 ctn.  2000    $ 132.00
2 ctn.  4000   $ 252.00
3 ctn. 6000
$ 360.00
4 ctn. 8000
$ 464.00
TO ORDER CALL
800-221-1209
 PRICE
PER 1,000
$ 66.00
$ 63.00
$ 60.00
$ 58.00
ELECTRONIC METER TICKETS
MID:COM - ROLL TICKETS
forms for Mid:com registers”
• Premium paper stock to ensure clear lasting image.
• Rolls are manufactured to exact specs to
ensure trouble free use in the field.
• Competitive prices lower your overhead.
• Compatible with Cognitive Blaster printer.
THERMAL ROLL
TICKETS
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
•
•
•
•
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
How To Close Gas Supply Valves
TURN
FORM #TSR4B
4 ⁄4” Wide, 330 ft., 1 ⁄4” core
Perfed every 81⁄2” with timing mark
With “Duty To Warn” backer
Packaged 8 rolls/ctn.
1
1
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
TSR4B
REORDER FORM # TSR4B FROM WEHOF FORMS (800) 221-1209
TSR4B.indd 1
3/2/11 2:39:54 PM
BACKER
FORM #TSR4
• 41⁄4” Wide, 330 ft., 11⁄4” core
• Perfed every 81⁄2” with timing mark
• Packaged 8 rolls/ctn.
PRICE
  1-6 ctn.
7-13 ctn.
14-20 ctn.
21-24 ctn.
25-38 ctn.
39-50 ctn.
51-63 ctn.
29
QTY.
8-48 rolls
56-104 rolls
112-160 rolls
168-192 rolls
200-304 rolls
312-400 rolls
408-504 rolls
TSR4
PER ROLL
$ 10.40/roll
$ 9.70/roll
$ 9.25/roll 
$ 8.95/roll
$ 8.30/roll
$ 7.20/roll
$ 6.80/roll
For higher quant i t ie s, call for a quo te .
20# Premium
Thermal Rolls
Blank or with
“Duty to Warn”
Backer
MID:COM CUSTOM FORMS
THIS IS YOUR BILL. PLEASE PAY FROM THIS INVOICE.
в—Џ
DELIVERY ADDRESS
в—Џ
в—Џ
в—Џ
INSTRUCTIONS
GALS. READING - START
TOTAL PRICE
GALS. READING - FINISH
SALES SEQUENCE NUMBER
PRODUCT COST
TAX
WEHOF FORMS • 800-221-1209
TERMS: Net 30 days
unpaid balance
subject to 2% charge per
month (24% per annum).
Minimum charge $1.00.
Please write account
number on check.
TERMS
BALANCE
LAST D.D.
JULIAN
PRINTED
FC
CASH
14751
DATE
CHECK
PRICE
(518) 966-8426
THIS IS YOUR BILL. PLEASE PAY FROM THIS INVOICE.
DELIVERY ADDRESS
в—Џ
REMOVE THIS STUB FOR MID:COM USE
ZO
TICKET NO.
NO REFUNDS AND/OR EXCHANGES
в—Џ
в—Џ
CL
LAST D.D.
141CR 406 • SOUTH WESTERLO, NY 12083
в—Џ
в—Џ
GALLONS
MAR-GAS LP SERVICE, INC.
в—Џ
в—Џ
PHONE
BILLING ADDRESS
PRICE PER GALLON - CENTS
Meter Tickets with or without
return envelopes, all designed for
MID:COM systems’ specifications.
Tickets for: MID:COM 8000 Series
MID:COM 6501 Series
ACCOUNT
DATE LAST
VOLUME CORRECTED TO 60В°F
в—Џ
WEHOF FORMS • 800-221-1209
в—Џ
ACCOUNT
PHONE
DATE LAST
GALLONS
CL
ZO
LAST D.D.
TERMS
BALANCE
JULIAN
DRIVER
PRINTED
INSTRUCTIONS
LP Service, Inc.
141CR 406
SOUTH WESTERLO, NY 12083
в—Џ
(518) 966-8426
TICKET
NO.
в—Џ
01234
DELIVERY DATE
FC
GALLONS
PRICE
SALES TAX
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
LAST D.D.
BILLING ADDRESS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
DATE
AMOUNT
в—Џ
в—Џ
BALANCE
LATE CHARGE
SUBTOTAL
в—Џ
PAYMENT
в—Џ
NO REFUNDS AND/OR EXCHANGES
www.FormsPro.net
CHECK
CASH
PAY THIS AMOUNT
в—Џ
30 ELECTRONIC METER TICKETS
NEPTUNE - RED SEAL MEASUREMENT
FORM #3-EMT
METER TICKET
REORDER FORM #3EMT FROM WEHOF FORMS 800-221-1209
4” X 113⁄4”; 3-Ply NCR Stock w/Hard
Back Copy 2000/ctn.
  QTY.
PRICE
1 ctn.    2000    $ 180.00
2 ctn.  4000    $ 348.00
3 ctn. 6000
$ 504.00
4 ctn. 8000
$ 648.00
5 ctn. 10000
$ 780.00
  PRICE
PER 1,000
T
#3-EM
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
DRIVER SIGNATURE
CHECK
IF TANK
NOT FULL
01001
CUSTOMER SIGNATURE
CASH
CHECK X
PAYMENT RECEIVED
$
For use in Neptune Meters. Use as a delivery ticket or a calibration ticket.
Top quality NCR stock for superior image transfer.
91⁄2” X 4” 3-Ply meter ticket
NCR stock; Pre-numbered
with hard back copy; secure
glue at right side edge;
2000/carton.
  QTY.
PRICE
1 ctn. 
2 ctn. 
3 ctn.
4 ctn.
2000
4000
6000
8000
   $ 132.00
  $ 252.00
$ 360.00
$ 464.00
MT
#3-B
  PRICE
PER 1,000
$ 66.00
$ 63.00
$ 60.00
$ 58.00
INSERT FACE UP
вћЄ
FORM #3-BMT
TOP END FIRST
REORDER FORM # 3-ST FROM WEhOF FORMS 1-800-221-1 209
FORM #3-ST
CERTIFIED METER DELIVERY
GALLON READING - START
41⁄8” X 73⁄4” Top Stub, Snapset Meter
Ticket, Carbonless with Hard Back
Copy on Ply 3.
IMPRINTING
$ 80.00/M
AVAILABLE
FORM #3-SB
#3-SB
00001
#3-ST
GALLONS DELIVERED
SOLD TO
PRODUCT
GALLONS
PRICE
10ThS
AMOUNT
SOLD TO
TAX
вћћ
THIS IS YOUR INVOICE
TOTAL
PRODUCT
GALLONS
PRICE
AMOUNT
CERTIFIED METER DELIVERY
GALLON READING- START
41⁄8” X 73⁄4” Bottom Stub, Snapset Meter
Ticket Carbonless with Hard Back
Copy on Ply 3.
$ 80.00/M
TAX
THIS IS YOUR INVOICE
IN TANK (APPROX)
GALLONS DELIVERED
IN TANK(APROX)
C.O.D.
CHARGE
RECEIVED
PAYMENT $
10THS
DATE
BY
C.O.D.
ChARGE
RECEIVED
PAYMENT $
20
REC’D ABOVE GALS.
TRUCK
CUSTOMER
SIGNATURE
NO.
вћЎ
TOTAL
DATE
BY
20
TRUCK
NO.
REC'D ABOVE GALS.
CUSTOMER SIGNATURE
TO ORDER CALL
INSERT FACE DOWN
вћЄ
Both sold in quantities of 1000
#3-ST7.indd 1
BOTTOM END FIRST
REORDER F O R M #3-SB FROM W E H O F F O R M S 1-800-221-1209
800-221-1209
4/1/10 1:54:49 PM
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE FORMS
GALLON READING - FINISH
GALLONS AUTOMATICALLY CORRECTED TO 60П’ F
YOUR SALE NO.
RMT-3
PREVIOUS SALE NO.
WEHOF FORMS 1(800) 221-1209
CUST. I.D.
S
O
L
D
LOC.
NEXT DELIVERY
D
E
L.
-3
#RMT
T
O
T
O
CODE
FORM #RMT-3
91⁄2” X 4”
Meter tickets
3-ply with carbonless paper
Hard Back Copy on Ply 3
Propane Safety Guidelines
Backer
GALLON READING - START
RURAL COMPUTER CONSULTANTS
DATE
DVR
TRK
REC’S ON ACCOUNT
ROUTE
% BEFORE
PRODUCT
SERIAL NO.
% AFTER
GALLONS
PRICE
SIZE
L/O
SIGNED
AMOUNT
LP-GAS
вќЏ CASH
вќЏ CHECK
вќЏ CHARGE
TOTAL
UNDERSIGNED AGREES TO PAY IN 30 DAYS
X
STATEMENT
Call for a Pr ice Quo te .
STOCK FORM #RLS
81⁄2” X 11”
1-ply Laser Statement
Premium White 24# Laser Bond
Propane Safety Guideline Backer
ACCOUNT I.D.
DATE
REFERENCE
LOC
DESCRIPTION
CHARGES
STMT. DATE
PAYMENTS
AMOUNT DUE
#RLS
UNPAID FINANCE
CHARGE
CURRENT
OVER 30 DAYS
OVER 60 DAYS
THE FINANCE CHARGE IS COMPUTED BY A PERIODIC RATE OF
UNDER $
OVER 90 DAYS
NEW FINANCE
CHARGE
NEW BALANCE TOTAL AMOUNT DUE
% PER MONTH (OR A MINIMUM CHARGE OF $
) WHICH IS AN ANNUAL PERCENTAGE RATE OF
FOR BALANCES
%. THE FINANCE CHARGE IS COMPUTED ON THE ADJUSTED
BALANCE. THE ADJUSTED BALANCE IS THE PREVIOUS BALANCE LESS PAYMENTS AND CREDITS APPEARING ON THIS STATEMENT.
TO INSURE PROPER CREDIT, PLEASE RETURN THIS STUB WITH YOUR REMITTANCE
STATEMENT
AMOUNT REMITTED $
ACCOUNT I.D.
STATEMENT DATE
TOTAL
AMOUNT
DUE
Please explain any differences
between the total amount due and the
amount of your remittance.
вћћ
FORM #TSR4B
•
•
•
•
•
41⁄4” Wide, 330 ft., 11⁄4” core
Perfed every 81⁄2” with timing mark
“Duty to Warn” backer
Packaged 8 rolls/ctn.
TSR4B
Premium 20# paper stock to
ensure clear lasting image.
• Rolls are manufactured to exact
specs to ensure trouble free use in the field.
• Competitive prices lower your overhead.
  QTY.
1-6 ctn.
7-13 ctn.
14-20 ctn.
21-24 ctn.
25-38 ctn.
39-50 ctn.
51-63 ctn.
8-48 rolls
56-104 rolls
112-160 rolls
168-192 rolls
200-304 rolls
312-400 rolls
408-504 rolls
PRICE
PER ROLL
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
TURN
How To Close Gas Supply Valves
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
REORDER FORM # TSR4B FROM WEHOF FORMS (800) 221-1209
TSR4B.indd 1
3/2/11 2:39:54 PM
“DUTY TO WARN”
BACKER
Blaster Printer
$ 10.40/roll
Cognitive Model
$ 9.70/roll
LBX42 - 2043
$ 9.25/roll 
Advantage LX
$ 8.95/roll
$ 8.30/roll
$ 7.20/roll Works with Automated
$ 6.80/roll Wireless, K&K Computing,
For higher quant i t ie s, call for a quo te .
TCS & Touchstar software
www.FormsPro.net
31
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE FORMS
SUBURBAN SOFTWARE
W
ehof Forms has been supplying
high quality custom forms for
Suburban software users for years.
Our Suburban customer list grows
every year because of our quality,
service and customer satisfaction.
Give us the opportunity to quote you
on your form requirements. You’ll be
pleasantly surprised.
• Professional Design
• Quick Delivery
• Knowledgeable Staff
A BETTER GAS COMPANY
WEHOF FORMS (800) 221-1209
P.O. Box 580
Commerce, Georgia 30530
(800) 749-6607 • (706) 335-4000
(706) 219-4000 • (706) 245-4411
DATE
REFERENCE
QUANTITY
DESCRIPTION
AMOUNT
ACCOUNT NO.
REFERENCE
PAYMENT
RETURN THIS PART WITH YOUR PAYMENT
“PAST DUE AMOUNT” subject to FINANCE CHARGE
PAST
DUE
AMOUNT
OVER 120 DAYS 91 - 120 DAYS
61 - 90 DAYS
31 - 60 DAYS
TOTAL
AMOUNT
DUE
ANNUAL RATE
MINIMUM
POST CARDS
в—Џ
в—Џ
520 POTTSTOWN PIKE
P.O. BOX 387
UWCHLAND, PA 19480
в—Џ
в—Џ
в—Џ
в—Џ
PHONE: 610-458-8389 • FAX: 610-458-0689
DATE
REFERENCE
DESCRIPTION
QUANTITY
AMOUNT
REFERENCE NO.
ACCOUNT NO.
WEHOF FORMS 800-221-1209
в—Џ
в—Џ
PAYMENT DUE
в—Џ
в—Џ
PLEASE DETACH AND RETURN THIS
PORTION WITH YOUR REMITTANCE.
в—Џ
в—Џ
AMOUNT
ENCLOSED $
REMIT TO:
в—Џ
в—Џ
в—Џ
STATEMENT DATE
REFERENCE
ACCOUNT NO.
в—Џ
PLEASE PAY TOTAL AMOUNT DUE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
TO SEAL: MOISTEN OTHER SIDE OF FLAP AND FOLD OVER.
PLACE STAMP
HERE
The Post Office
will not deliver
mail without
Postage
Check if this is a new address.
Quick De li ver y!
PO BOX 387
UWCHLAND PA 19480
INVOICE / STATEMENT MAILER
DR-ZONE
20% DEL
CR-DEL
RUN OUT
GALS.
USE
G.P. DD
G.P. DAY
TANK SIZE GALS. LAST YEAR
ACCOUNT NO.
SALESMAN
TIME DEL.
DELIVERY DATE
PCT. START
CONFIDENCE
QUANTITY
AMOUNT
TIME
AM
SPECIAL DELIVERY
CHARGE
%
PREPAID
PM
FILL
(OR)
AMT:
CASH
(OR)
CHARGE
PRESSURE TEST
PAID IN OFFICE
AMOUNT DUE
$
ODOR WAS DETECTED IN GAS
P.O.BOX 286
CUMMING, GA 30028
WEHOF FORMS 800-221-1209
CHECK
DIRECTIONS
/
SALES TAX
CASH
%
GAS ORDER
/
DATE
PCT. FULL
PRICE
PREVIOUS DELIVERY
в–ј
PHONE NO.
в—Џ
в—Џ
Hazardous Workplace
Assessment Document
в—Џ
в—Џ
в—Џ
в„ў
Order Number
Date Ordered
Taken By
Schedule Date
Branch - Customer No.
Home
Work
Time Started
Date Completed
A.M. Time Completed
A.M.
P.M.
P.M.
Directions to Location:
Name and Address
в—Џ
X
в—Џ
в—Џ
RECEIVED BY
BRANCH COPY
Work to be Performed:
в—Џ
Rent
вќ’
Own
вќ’
в—Џ
SS#
L.L. Name, Address & Phone
в—Џ
в—Џ
METER TICKET
в—Џ
Usage:
в—Џ
в—Џ
в—Џ
DR-ZONE
20% DEL
GALS.
USE
CR-DEL
RUN OUT
G.P. DD
G.P. DAY
TANK SIZE GALS. LAST YEAR
в—Џ
PHONE NO.
ACCOUNT NO.
REFERENCE NO.
DELIVERY DATE
TRUCK NO.
PCT. FULL
CONFIDENCE
QUANTITY
PREVIOUS DELIVERY
в—Џ
в—Џ
в—Џ
GAS ORDER
DATE
FILL
CASH
/
/
(OR)
(OR)
SALESMAN
PRICE
SALES TAX
CHECK
DIRECTIONS
CHARGE
%
в—Џ
в—Џ
AMOUNT
CASH
%
в—Џ
TICKET NO.
OLD BALANCE
в—Џ
в—Џ
PREPAID
AMT:
AMOUNT DUE
CHARGE
A BETTER GAS COMPANY
P.O. BOX 580
COMMERCE, GA 30530
(706) 219-4000 (706) 335-4000
(800) 749-6607 (706) 245-4411
AMOUNT PAID
$
$
в—Џ
в—Џ
в—Џ
RECEIVED BY
Fireplace
QTY.
вќ’
New
вќ’
Reconditioned
Materials
Price
Amount
в—Џ
в—Џ
COMPANY EQUIPMENT ON LOAN
Pump Make
Serial No.
Tank Make
Size
Motor Make
Serial No.
Regular Date Reg. Condition
в—Џ
Serial No.
Paint Condition Gals in Tank
Model
Mfr.
Vent Pos
в—Џ
Protected?
в—Џ
TWO 1st
STAGE 2nd
в—Џ
Less Check
Flow Check
Manometer Reading at Start Manometer Reading after Manometer Reading under
Load
10 minutes
Central Heating
Water Heater
Lock-up Check
Manometer Reading
вќ’
вќ’
вќ’
Clothes Dryer
Range
Manufacturer
в—Џ
Model No.
в—Џ
Sed. Trap
Vent
Fuel вЃ„ BTU
в—Џ
в—Џ
в—Џ
On Acct.
Hour вЃ„ Labor Billed
Total This Invoice
000
N/A
000
N/A
Expiration Date
в—Џ
CUSTOMER AVAILABLE
вќ’
CONTAINER & VALVES
вќ’
PIPING & FITTINGS
вќ’
REGULATOR
вќ’
ODOR CHECK
TO ORDER CALL
в—Џ
Card
Type
вќ’ YES вќ’ NO
CUSTOMER SMELLED ODORIZED PROPANE
AND SHOWN THE SHUTDOWN PROCEDURE
вќ’ YES вќ’ NO
CUSTOMER ACKNOWLEDGEMENT
BROCHURES LEFT WITH
Representative
Date
• The Installation Review has been completed on my gas system if indicated above.
CUSTOMER
• I know how to turn off gas in case of emergency.
“SCRATCH & SNIFF”
• I have smelled propane and can detect its odor.
Customer Signature
Date
INSTALLATION REVIEW
• I have received the Consumer Safety Information and material.
• I understand propane is flammable and can be explosive.
• 90 Day Conditional Parts & Labor Warranty
• I know what to do when I smell gas.
• I have had gas system deficiencies and/or corrections, if any, clearly explained to me. • TERMS: Net 30 Days - 1.5% Interest on Past Due accounts. $30.00 Late Fee assesseD on
aLL accounts over 30 Days, PrIcIng guarantees & contracts are subject to change anD
• I have reviewed the safety information and recommendations on the back of this form.
May be consIDereD nuLL & voID When account FaLLs Past 30 Days.
SEE IMPORTANT SAFETY INFORMATION ON BACK.
вќ’
вќ’
GAS CHECK FORM
METER TICKET
в—Џ
Sales Tax
Credit Card No.
000
Shut off
Installed
Installation
Review
Cash
вќ’ Currency вќ’ Check #
Age
в—Џ
Charge
Amount Paid
Serial No.
в—Џ
X
в—Џ
Grain Dryer Type of Tanks Needed:
SINGLE
STAGE
в—Џ
ODOR WAS DETECTED IN GAS
в—Џ
WEHOF FORMS (800)22101209
в—Џ
вќ’ Pool Heater вќ’ Commercial вќ’ ForkLift
вќ’ Refrigerator вќ’ Generator вќ’
вќ’ Industrial вќ’ Stove
вќ’ Waterheater вќ’ Dryer
вќ’ Heating вќ’
Work Completed:
в—Џ
WEHOF FORMS 800-221-1209
32
800-221-1209
в—Џ
в—Џ
в—Џ
PROPANE MARKETPLACE - SOFTWARE COMPATIBLE FORMS
DeYOUNG
в—Џ
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WORKORDER / INVOICE
q NEW CUSTOMER
q EXISTING CUSTOMER
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TAKEN BY:
DATE:________________
Equipment Service and Appliance Sales are provided by Inergy Services.
CUSTOMER NAME
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TIME:________________
APPOINTMENT:
DATE:________________
ADDRESS
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CITY, STATE, & ZIP
TIME:________________
ACCOUNT NUMBER
ALTERNATE ADDRESS
HOME
CITY, STATE, & ZIP
CELL
REGULATOR PRESSURE TEST:
INTEGRAL TWIN STAGE
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1ST STAGE
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LEAK TEST:
2ND STAGE
2ND STAGE (If applicable)
HIGH PRESSURE: TP less 10 psi
LEAK TEST:
INTERMEDIATE: 1st stage less 5 psi
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PRESSURE TEST: 1.5 x W.P. (MIN 3 PSI)
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r TANK/EQUIPMENT: COMPANY OWNED__________CUSTOMER OWNED__________
r TANK/EQUIPMENT REMOVAL:
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r OUT-OF-GAS*
r LIT PILOTS*
QTY
REORDER FROM WEHOF FORMS 1(800) 221-1209
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r CYCLED APPLIANCES ON/OFF*
r DISCONNECT (Lockout Tank) TAG* # ________________________________________
r RECONNECT*
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*Follow company’s policies and procedures
Size
Mfr
Date of
MFR/REQUAL
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Lock-Up
Make
Model #
Mfr Date
PSIG
PSIG
IN W.C.
IN W.C.
IN W.C.
IN W.C.
PSIG
System Pressure
PSIG
Test Medium
Circle one:
Air or Inert Gas
Mfr
Meter
APPLIANCES:
IN W.C.
IN W.C.
Tank Pressure
Size
Mfr
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Date
Serial #
Model
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Space Heater
End
PSIG
Time Held
MINUTES
PSIG
START
End
PSIG
Time Held
MINUTES
PSIG
IN W.C.
End
PSIG
Time Held
PSIG
MINUTES
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Clothes Dryer
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Other
$ Per Item
SUMMARY
Total
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CUSTOMER’S SIGNATURE:
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TIME: END____________ AM/PM
DATE:
EMPLOYEE’S SIGNATURE:
NEW CUSTOMER ACKNOWLEDGEMENT
CUSTOMER – CANARY
FILE – PINK
DATE:
Refer to the BACK SIDE of this document for Important Safety Information
FORM# DYS 1
WEHOF FORMS 1(800) 221-1209
... Due From Last Month
в—Џ
Pay this Amount
в—Џ
DELIVERED TO:
в—Џ
в—Џ
в–І
Please Detach Here and Return Upper Portion with Your Payment
Balance Last Statement
Date Last Statement
Your Account Number
Date of this Statement
в—Џ
в–І
в—Џ
Present Balance
Pay This
Amount
DATE
TYPE
CODE
DESCRIPTION
MEMO
UNITS
NET AMOUNT
TAX
TOTAL AMOUNT
BALANCE
в—Џ
в—Џ
-1
#DYS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
STATEMENT - Retain this portion for your records
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FORM #DYS-W
91⁄2” x 11” Work Order/Invoice
3-ply; printed in blue ink
with gray safety backer
on carbonless stock.
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Recd by:
BACKER - VTR4B
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I,
(Please print name) • can detect the odor of propane and know how to turn off the gas supply in case of emergency.
• have received the propane safety information pamphlet (PERC) Propane Education & Research Council. • understand my gas company representative did not conduct a
comprehensive inspection of my entire gas system. I understand this inspection covers propane/LP-Gas items and equipment visible and accessible to the service technician and
represents the conditions existing on the date of the inspection and does NOT cover latent or manufacturing defects, the internal working of sealed equipment or structural components
or vent systems and cannot be construed to cover future or unforeseen happenings. • had gas system deficiencies and/or corrections, if any, clearly explained to me and am satisfied
with the service work performed.
COMPANY USE ONLY:
ORIGINAL – WHITE
Your Monthly Budget Amount
% Per Annum
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CASH or CHECK # ______________
A late charge may be assessed on unpaid balances at 1.50% per month (18% APR).
“I certify that the above-noted information and test results are accurate”.
TIME: START__________ AM/PM
PRINT NAME:
в—Џ
A Finance Charge at
% Per Month which is
may be Charged on Balances over 30 Days Old.
....Budget Customers Only
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AMOUNT RECEIVED $
DATE:
Account Number
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TOTAL BILLING $
PRINT NAME:
Amount Enclosed
в—Џ
в—Џ
в—Џ
в—Џ
Statement Date
в—Џ
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в—Џ
в—Џ
STATEMENT
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в—Џ
DATE
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LABOR
OTHER
SALES TAX
“I am satisfied with the work performed and agree to pay for services completed”.
APR).
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PAYMENT TYPE
% PER MONTH (
RECEIVED ON ACCT
% BEFORE
% AFTER
DELIVERY
DELIVERY
GOODS RECEIVED BY
DRIVER
Date
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IMPORTANT INFORMATION ON PROPANE SAFETY
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WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
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FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
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1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
How To Close Gas Supply Valves
Shut-off
valve here
Shut-off
valve here
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
RE-ORDER FORM # VTR4B AVAILABLE FROM WEHOF FORMS
VERTRAX ROLL TICKETS
FOR BULK QUANTITIES AND CUSTOM OPTIONS
CALL FOR PERSONAL ASSISTANCE.
VTR
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
TURN
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PROD CODE
APPLIANCE
NEW CUSTOMER’S SIGNATURE:
в—Џ
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AMOUNT
PARTS/FITTINGS
REV 06/10 FORM ID# 1001
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CASH
CHARGE
SNIFF
TEST
DELIVERY INSTRUCTIONS
в—Џ
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DESCRIPTION:
в—Џ
в—Џ
в—Џ
в—Џ
TOTAL
TERMS
A LATE CHARGE MAY BE ASSESSED ON UNPAID BALANCE
в—Џ
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AMOUNT
в—Џ
FOR INQUIRIES CALL
AT
PRICE
TAX STATUS
в—Џ
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MINUTES Gas Logs
IN W.C.
START
Kitchen Range
Water Heater
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Serial #
Furnace
START
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ASME / DOT
ASME / DOT
METER:
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ASME / DOT
Delivery
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r NEW CUSTOMER-OWNED ACCOUNT*
W
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•
C
O
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M
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N
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% BEFORE____________ % AFTER____________
SIZE_____________ SERIAL # _____________________________________________
r NEW CUSTOMER INSTALLATION*
ASME / DOT
LOW PRESSURE: 9” w.c. +/- 1/2” w.c.
PRESSURE TEST (NEW PIPING):
CHECK TYPE OF SERVICE:
r OTHER SERVICE explain:__________________________________________________
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Circle Type
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CREDIT STATUS
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#DYS
PROJECTED R/O DATE
в—Џ
97⁄8” X 8” Statements
1-ply 20# White Bond Stock
2500/Carton
$ 29.00/M = $ 72.50/ctn.
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в—Џ
PREVIOUS DEL DATE
UNITS
в—Џ
FORM #DYS-1
в—Џ
INVOICE NO.
ROUTE/SEQ
PROJ. DEL DATE
STOP
в—Џ
REORDER FROM WEHOF FORMS 1-800-221-1209 FORM DYS-4
в—Џ
ACCOUNT #
TICKET DATE
READING
в—Џ
METER
в—Џ
START
105⁄8” X 4” Meter Tickets
3-ply with Carbonless Paper
Hard Back Copy on Ply 3
Propane Safety Guideline
Backer; 1500/Carton
$ 73.00/M = $109.50/ctn.
L.P. GALLONS AUTOMATICALLY CORRECTED TO 60o F.
FORM #DYS-3
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
Fits Zebra
Model RW420
Wehof Forms is now supplying high quality, stock and custom printed roll tickets
for the Vertrax Mobile Platform. The Vertrax Mobile Platform perfectly ties together
SmartDrops Route Planning and Live Tracking to create one of the industry’s most
comprehensive delivery management systems. With Wehof Forms custom or stock
rolls in your trucks, you will present your customers with a detailed, exact accounting
of the delivery.With tough Mobile Printers and a touchscreen tablet PC your driver will
have unparalleled control of the delivery. Look no further than Wehof Forms for your
Vertrax Forms to show your customer your brand image.
FORM #VTR4 or #VTR4B
• 4” Wide, 80 ft., 3⁄4” core
• Blank roll Perfed every 81⁄2” with
 timing mark and “Duty to Warn”
 backer on Form #VTR4B.
• Packaged 25 rolls/ctn.
1-4 ctn.
5-8 ctn.
9-12 ctn.
13-16 ctn.
17-20ctn.
www.FormsPro.net
$ 5.25/roll
$ 4.50/roll
$ 3.75/roll
$ 3.25/roll
$ 2.90/roll
33
34 PROPANE MARKETPLACE - SOFTWARE COMPATIBLE FORMS
CARGAS
W
Proven Solutions for the Energy Industry
ehof Forms is now supplying
high quality, custom printed business forms to
CARGAS Energy software users! We expect
our CARGAS Energy Software customer list to
grow rapidly because of our quality, service
and customer satisfaction! By combining our
quality forms with CARGAS’ comprehensive
software solution, you will position yourself
for trouble free business operations. Give us
the opportunity to quote on your CARGAS
forms requirements.
LASER FORM
REORDER FROM WEHOF FORMS (800) 221-1209 • www.formspro.net
SUPERIOR
REORDER FROM WEHOF FORMS (800) 221-1209 • www.formspro.net
Providing Superior Fuels & Services for Over a Century
ACCEPTS:
(508)753-1475 (508)865-1972
www.cksmithsuperior.com
BILL TO
ONE STOP SHOP
ADDRESS
IF YOU WISH TO PAY BY CREDIT CARD, PLEASE VISIT www.emoyer.com
AND FOLLOW DIRECTIONS ON THE BACK PANEL OF THIS INVOICE.
CARGAS-LASER FORM.indd 1
• Commercial
Fuels
services 67 cities and
towns in Massachusetts
• Propane
• Plumbing
• Service Plans
• Equipment
Installations
• 24 Hour
Emergency
Service
A finance charge
computed at the
periodic rate of
1.5% per month
($1.00 Minimum)
will be added to
balances 30 days
past due from
date of invoice.
This is an annual
percentage rate
of 18%.
Budget Customer
payments due by
the 15th of each
month.
r NOT FULL
INVOICE
Ashland
Auburn
Barre
Berlin
Blackstone
Bolton
Boylston
Brookfield
Charlton
Charlton City
Charlton Depot
Cherry Valley
Clinton
FROM
Douglas
Dudley
East Brookfield
East Douglas
East Princeton
Fiskdale
Fitchburg
Framingham
Grafton
Holden
SUPERIOR
Holliston
Hopedale
Hopkinton
Hubbardston
Jefferson
Lancaster
Leicester
Leominster
Marlborough
Mendon
Milford
Millbury
Millville
Morningdale
North Brookfield
North Grafton
North Oxford
North Uxbridge
Northborough
Northbridge
Oakham
Oxford
Paxton
Office Locations
вћЎ
вћЎ
• Air Conditioning
We Sell Propane & Heating Fuels
GO GREEN with
DELIVERY
ADDRESS
Point, Click & Pay!
Having trouble setting
up your account?
Moyer Indoor
| Outdoor,
we’re going
green | Radon Protection
At any time,
you canQuality
easily... | Pest Control | Plumbing
| Home
| Water
Heat & Air |AtHeating
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Security
Services
We can help you.
AND making it easy for you to join us! Our new
• Pay
your heating
online
at your
| Gutter Care
Lawn Care | Tree
& Shrub
Carefuel| bill
Pool
& Spa
Care
you can
online “Easy Account” makes it simple!
Princeton
Rochdale
Rutland
Shrewsbury
South Grafton
South Lancaster
Southborough
Southbridge
Spencer
Sterling
Sturbridge
Sutton
Upton
Uxbridge
Webster
West Boylston
West Brookfield
Westborough
Westminster
Whitinsville
Worcester
PLEASE PAY THIS AMOUNT
Worcester, Millbury, Oxford & Upton
BILL TO
ADDRESS
215-799-2000
convenience
count on Call us at 215-799-2003.
• Choose your payment plan and pre-buy
Our online specialists
• Heat & Air
your fuel
will be happy to help
• Security
• Check your account balances, delivery• Radon
you step by step.
schedule & more
Protection
1. Go online to www.emoyer.com
2. Click on Pay Your Bill
3. Click on Make a Payment Button / Heating Fuels
4. Follow instructions to setup your “Easy Account”
• Pest Control
• Heating Fuels
If you would like to continue paying your oil bill by mail we will provide return envelopes. Please call our office at 215-799-2003.
• Water Quality
• Plumbing
PA989
• Lawn Care
• Tree & Shrub
Care
• Gutter Care
• Pool & Spa
Care
PLACE
STAMP
HERE
VOLUME DELIVERED
ADJUSTED TO 60ВєF.
IMPORTANT
BUDGET CUSTOMERS
THIS IS A MEMO
INVOICE;
CONTINUE WITH
YOUR PAYMENTS
TERMS
SUPERIOR
NET 30 DAYS SEE REVERSE SIDE
FOR ADDITIONAL
TERMS AND
CONDITIONS
48 PROVIDENCE STREET
PO BOX 566
MILLBURY MA 01527-0566
PLEASE PAY THIS AMOUNT
IMPORTANT SAFETY INFORMATION ANDMAILING
CONDITIONS
ON BACK
INSTRUCTIONS
• Write check for amount due.
CHECK
CASH
• Write account number on check.
r transferrtape and fold over to seal envelope.
$
• Remove
• Place stamp on envelope and mail.
THIS IS YOUR INVOICE
REC'D
PAYMENT
вћЎ
вћЎ
• Heating Oil
1. 24 Hour Emergency Service by Our Licensed Technicians
2. Comprehensive Service Plans
3. Annual Preventative Maintenance Included with all Service Plans
4. Heating/Air Conditioning Service and Installation
5. Propane and Plumbing Service
6. Automatic Fuel Oil Delivery
7. Convenient "Smart Pay" Budget Plan
8. Automatic Payment Options
9. Price Protection Program
10. $50 Referral Fee
В®
Menu of Services
DELIVERY
ADDRESS
4/19/12 4:27 PM
OFFICE
ADDRESS
PO BOX 64198
SOUDERTON, PA 18964-0198
PHONE: (215) 799-2000
www.emoyer.com
Office Copy
OFFICE COPY
METER TICKET
W/ENVELOPE
DATE
FORM #LBC-1 LASER
BUDGET COUPON
81⁄2” X 14”; 1-Ply White 24#
Laser Bond with Payment
Record Backer
1000/carton
$ 118.00/M $ 118.00/ctn.
GALLONS
DELIVERY RECORD
AMOUNT $
DATE
GALLONS
AMOUNT $
PAY M E N T
RECORD
# DATE CHECK NO. AMOUNT $
1
2
3
4
5
6
7
8
9
10
11
12
FUEL OIL
BUDGET PAYMENT PLAN
Below are your BUDGET PAYMENT COUPONS. You will find
a coupon for each of your 11 payments. The PAYMENT AMOUNT
and the month for which it is due will appear in the box of each
coupon. The 12th coupon is to be used for any balance due.
-1
#LBC
TOTAL AMT. REC’D �
BALANCE DUE PAYMENT COUPON
TOTAL
AMT. PAID
пїЅ
ACCOUNT
NO.
BALANCE DUE
-1
#LBC KER
BAC
ACCOUNT NO.
PAYMENT DUE
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #9
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #8
BUDGET PAYMENT COUPON – #7
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #6
BUDGET PAYMENT COUPON – #5
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #4
BUDGET PAYMENT COUPON – #3
ACCOUNT NO.
ACCOUNT NO.
PAYMENT DUE
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #2
BUDGET PAYMENT COUPON – #1
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
TO ORDER CALL
PLEASE PAY THIS AMOUNT
BUDGET PAYMENT COUPON – #10
PLEASE PAY THIS AMOUNT
*Imprinting available to
customize with logos, etc.
BUDGET PAYMENT COUPON – #11
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
800-221-1209
PROPANE MARKETPLACE - USEFUL PRODUCTS
GAS WARNING LABEL
IF YOU SMELL GAS, DON'T LIGHT IT.
IF YOU CAN'T LIGHT IT, DON'T FIGHT IT!
IF YOU SMELL GAS OR SUSPECT A LEAK
DON’T TOUCH electrical switches, light matches, or use the phone.
GET EVERYONE OUT of the building.
SHUT OFF the gas valve at the outside tank, meter, or service
entrance.
CALL your gas supplier and/or the fire department from a neighbor’s
phone.
6” X 4” “Duty to Warn” label can be applied to wall or
equipment to educate customers on safety procedures.
Matte Finish • Permanent Adhesive • Any Standard Color
IF PILOT LIGHT WON’T LIGHT
(Read appliance operating instructions before attempting to light
pilot).
If you have trouble lighting the pilot or keeping it lit, there’s
normally a safety feature preventing it from working. If it won’t
light, shut off the gas and call your gas supplier.
TAMPERING IS DANGEROUS
Do not force the gas control knob. Never use tools. Use only your
hand to turn the control knob. Forcing the gas control knob may
override the safety feature and allow gas to leak. This could
result in fire or explosion.
500 Labels
1000 Labels
2000 Labels
3000 Labels
5000 Labels
If the gas control knob becomes difficult to operate by hand, the
appliance should be serviced by a trained gas service person.
GAS HAS BEEN ODORIZED
Before lighting, sniff all around the appliance area for a gas odor.
Be sure to sniff next to the floor because propane gas is heavier
than air and may temporarily exist at floor level.
ODOR DEPLETION
In certain circumstances the L.P. Gas odor may diminish or weaken
making it difficult for a person with a normal sense of smell to detect
a gas leak.
If a leak is suspected, contact your L.P. Gas dealer.
WATER DAMAGE
If your gas control valve has been subjected to flooding or wetting, it
must be inspected by a trained gas service person prior to starting
and replaced if damaged or required by the manufacturer’s
instructions.
YOUR COMPANY’S NAME HERE
123 MAIN STREET
CITY, STATE 12345
$ 100.00/lot
$ 120.00/lot
$ 215.00/lot
$ 290.00/lot
$ 425.00/lot
*Also available in vinyl w/lamination. Please call for a quote.
(123) 456-7980
PROPANE TANK LABELS
Permanent outdoor vinyl labels for propane tanks and equipment for identifying
accounts, displaying logos, and providing safety information.
Call for a price
quote and samples
PROPERTY OF:
MID STATES PROPANE
FOR SERVICE CALL:
913-422-1747
“NOT AT HOME” TAG
REORDER FORM # NOH-3 FROM
FROM WEHOF FORMS 800-221-1209
NO ONE WAS HOME
NO ONE WAS HOME
AVISO DE NADIE EN CASA
AVISO DE NADIE EN CASA
(Name of LP Gas Company)
(Nombre de Compania de Gas LP)
Call us at _____________________ and arrange to have
pilots lit and your appliances put back into operation.
If screen door is
or there is
(Name of LP Gaslocked
Company)
(Nombre de Compania de Gas LP)
not a door knob
Call us at _____________________
and arrange to have
present, remove
pilots lit andtape
your
appliances
put back into operation.
liner
and
apply
to clean
(Llamenos al… para
prender
los pilotos y poner todos sus aparatos en funcion.)
door surface in
a conspicuous
place.
Thank You.
(Llamenos al… para prender los pilotos y poner todos sus aparatos en funcion.)
Thank You.
Gracias.
Address
Customer
IMPORTANT INFORMATION ON PROPANE SAFETY
Date
Address
Time
Remarks
By:
вќ’
вќ’
вќ’ SERVICE
1/2” Kleenstick Tape/
вќ’ SERVICE
Customer
вќ’ DELIVERY
Date
Gracias.
вќ’ DELIVERY
Complete and return to office customer file for follow up.
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
Remarks
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
Time
By:AN ODOR ADDED SO YOU
FOR YOUR SAFETY, PROPANE HAS
Complete
and return
to office customer file for follow up.
CAN DETECT LEAKS . . . You and each member
of your
family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
We
found
tank empty when we
than air and will collect at floor level. Carefully
smell
at floor your
level and
in low spots to check for propane.
вќ’
delivered gas.
(Encontramos su tanque vacio cuando repartimos el gas.)
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
We found your tank empty when we delivered
gas.
вќ’ We interrupted your gas service while servicing your
Put out all smoking materials and any other open flames.
(Encontramos su tanque vacio cuando repartimos el 1.
gas.)
2. Do not operate any appliances, switches
or thermostats.(Interrumpimos su servicio de gas cuando dimos
installation.
3. Get everyone outside and away from gas equipment.
4. Shut off the
gas supply, using the shut-off
valve a
at su
the instalacion.)
tank
servicio
We interrupted your gas service while servicing
your
or cylinder.
installation. (Interrumpimos su servicio de gas 5.cuando
Call yourdimos
propane supplier - use your neighbor’s phone - if gas
smell is in the house.
your
servicio a su instalacion.)
6. Stay outside and leave the gas offFor
until the
leak safety
has been we left the supply tank valve closed.
found and fixed.
(Para su seguridad dejamos la valvula de provicion del tanque cerrada.)
How To Close Gas Supply Valves
For your safety we left the supply tank valve closed.
TURN
(Para su seguridad dejamos la valvula de provicion del tanque cerrada.)
HOW TO CLOSE GAS
WARNING
SUPPLY VALVES: FLAMMABLE COMPRESSED GAS
EXTREMELY
If you are unsure and/or
your installation
does not
Failure
to follow
these instructions could cause personal
WARNING
look like this diagram, call
us at
the telephone
numbodily
injuries
resulting
from - FIRE, EXPLOSION OR CARBON
EXTREMELY FLAMMABLE COMPRESSED GAS
ber listed on the front of
this delivery invoice.
MONOXIDE
POISONING.
Failure to follow these instructions could cause personal
DO NOT OPEN TANK VALVE!
bodily injuries resulting from - FIRE, EXPLOSION OR CARBON
RELIGHTING YOUR PILOTS.
MONOXIDE POISONING.
We strongly recommend that for safety reasons, you call a
qualified technician to relight your pilots.
DO NOT OPEN TANK VALVE!
pilots yourself:
However, if you relight the
ADVERTENCIA
a. Turn all appliance controls and manual shut-off valves to the
ADVERTENCIA
GAS COMPRESADO EXTREMADAMENTE INFLAMABLE
OFF position.
b. Slowly open the tank shut-off valve.
No
estas
instrucciones
podria causar heridas personales
c. Carefully smell for the presence
of seguir
propane at
floor level
and
low spots before attempting topor
relight
the pilot. de: FUEGO, EXPLOSIONES O EMBENENAMIENTO
resultado
GAS COMPRESADO EXTREMADAMENTE INFLAMABLE
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
CON MONOXIDO DE CARBONO.
No seguir estas instrucciones podria causar heridas personales
e. Follow the manufacturer’s instructions for pilot lighting.
NO ABRIR LA
por resultado de: FUEGO, EXPLOSIONES O EMBENENAMIENTO
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTCON MONOXIDO DE CARBONO.
VALVULA!
IN SAFETY FEATURES . . .to help keep them working:
NO ABRIR LA VALVULA!a.
Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
Immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
01001
01001
STOCK FORM #NOH-3
Notify your customer that you have made a
delivery when they were not at home and that
the main valve is closed. The copy is in English
and Spanish. 3 ply tag consists of:
♦ Ply 1 - Tag with wire to be attached to
the tank valve. “Duty to Warn” on reverse
side.
♦ Ply 2 - Office copy for follow-up.
♦ Ply 3 - Door knob notice with
self-adhesive tape option if screen door is
locked. NCR stock with “Duty to Warn”
on reverse side.
Tag has a wire tie, doorknob die cut hole, and
pressure sensitive adhesive tape.
500
1000
2000
3000
5000
$ 290.00/M
$ 270.00/M
$ 250.00/M
$ 240.00/M
$ 230.00/M
$ 145.00/lot
$ 270.00/lot
$ 500.00/lot
$ 720.00/lot
$1150.00/lot
Custom orders available - 2000 minimum.
www.FormsPro.net
35
36
PROPANE MARKETPLACE - USEFUL PRODUCTS
PROPANE DELIVERY REPORTS
REORDER FORM #LPDR-1 FROM WEHOF FORMS 800-221-1209 www.formspro.net
PRODUCT LOADINGS
LOADED AT
TICKET #
WEHOF FORMS 800-221-1209
FUEL DELIVERY REPORT
вњЇвњ® вњЎвњЈвњЈвњЇвњµвњ®вњґ
✣✯✬✬✥✣✴✥✤
вњЎвњ­вњЇвњµвњ®вњґ
✧✡✬✬✯✮✳ ✧✡✬✳✎✲✥✭✡✩✮✩✮✧
✣✵✳✴✯✭✥✲
вњ”
TOTAL
LOADED
ON TRUCK
STARTING
PRODUCT
U.N. 1075
Liquefied Petroleum Gas
2.1 (Flammable
Gas)
✴✩✣✫✥✴
U.N. 1075
вњ‘
Liquefied Petroleum Gas
2.1 (Flammable Gas)
U.N. 1075 вњ’
Liquefied Petroleum Gas
2.1 (Flammable
вњ“ Gas)
OTHER:
GALLONS
вњ•
DELIVERY RECONCILIATION
вњ–
-1
LPDR
METER
FINISH
GALLONS
LOADED
TOTAL TO
ACCOUNT FOR
ON TRUCK
FINISH
вњ�
TOTALIZER
DELIVERED
TELEPHONE
EXPENSE
LOST TIME
#LPDR-1
вњ—
METER
START
#
GALLONS
DELIVERED
вњ™TIME
FINISH
вњ‘вњђ
START
вњ‘вњ‘
TOTALS
ER
BACK
MILES
One-Part Card Stock
500 Sheets
1000 Sheets
2000 Sheets
3000 Sheets
5000 Sheets
вњ‘вњ’
DRIVER’S PRE-TRIP / POST-TRIP CHECK LIST
PRE-POST
вњ‘вњ“
BOBTAILS AND TRACTORS- Chassis
PRE-POST
PRE-POST
вњ‘вњ”
Battery
Body
Air Compressor
Air Lines
Brake Lines
Brakes, Parking
Brakes, Service
Clutch
Coupling Equipment
Defroster/Heater
Drive Line
Belts
Hoses
Fluids
Fifth Wheel
Frame & Assembly
Front Axle
Fuel Tanks
Alternator
Horn
Headlights
Tail Lights
Turn Signals
Other Lights
Mirrors
Exhaust
Oil Pressure
Radiator
Radio/Telephone Com
Rear End
Reflectors
Fire Extinguisher
Reflective Triangles
Spare Bulbs/Fuses
Cargo Tank
Fusible Elements
*Off Truck Remote
*Delivery Hose ID Mark
Leak Inspection
вњ’вњ” Pipe Inspection
New/Repaired Hose
Pressure Test
Emergency Discharge
вњ’вњ•
Appearance/Condition of Hoses
Control System
вњ‘вњ•
вњ‘вњ–
вњ‘вњ—
вњ‘вњ�
вњ‘вњ™
Spare Seal Beam
Suspension
Starter
Steering
Tachograph
Tires & Rims
Placards/Markings
Tire Chains
Transmission
Windows
Windshield Wipers
WRITTEN PROCEDURES
вњ’вњђ
вњ’вњ‘
Emergency Shutdown
Unloading Procedure
Operating Procedure
вњ’вњ’
BOBTAILS - Metered Service
вњ’вњ“
HOSES
PIPING SYSTEM
вњ’вњ–
TRANSPORT - Non-Metered Service
HOSES
PIPING SYSTEM
*Delivery Hose ID Mark вњ’вњ—
Leak Inspection
New/Repaired Hose
Pipe Inspection
Pressure Test
вњ’вњ� Emergency Discharge
Appearance/Condition
Control System
of Hoses
вњ’вњ™
*Passive/Remote Shutdown Systems
Brakes
Cargo Tank
Coupling Equipment
Tires/Wheels
Landing Gear
Lights
Date Defects Corrected:
вњ“вњ’
This vehicle is safe to operate although the above defects were noted (Mechanic must sign)
вњ“вњ“
Driver’s Signature
Supervisor/Mechanic
Signature (Sign only if defects listed):
Date:
вњ“вњ”
$ 25.00/lot
$ 40.00/lot $ 70.00/lot
$ 94.50/lot
$ 145.00/lot
Propane Delivery Reports are available to
consolidate loading, delivery, and truck safety
information on one easy to use form. Organized
for better efficiency in daily operations.
вњ“вњђ
TRANSPORT - Non-Metered Service
вњ“вњ‘
Defects Noted:
Designed to fit Aluminum Meter Ticket Holders.
Top Quality 32# Stock
 Date:
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
вњ“вњ•
OUT OF GAS LEAK CHECK FORM
REORDER FORM OGLC-3 FROM WEHOF FORMS (800) 221-1209
NEW
ITEM
OUT OF GAS LEAK CHECK FORM
DATE:
NOTE TO DRIVER вЃ„ TECHNICIAN: Complete this form for all
Out-Of-Gas customers in accordance with the Company’s
Out-Of-Gas policy.
Customer Name:
Safety Notice
PROPERTIES OF PROPANE GAS:
• Propane is a flammable gas that can cause fires and explosions.
• Propane is heavier than air and can collect in low places (along
the floor, in basements, etc.)
• Propane has been odorized so you can smell it.
Customer #:
Address:
City
State
ZipIF YOU DETECT AN ODOR:
• Open windows and doors to increase ventilation.
• DO NOT light matches or cigarettes.
• DO NOT operate switches, electrical appliances, thermostats or
Telephone #:
telephones. They may cause a spark to ignite escaping gas.
LEAK CHECK RESULTS
• Check to be sure all pilots are burning.
• Ifless
the source
(Tank Pressure (TP)
10 psi) has not been detected, get everyone out of the
building and shut off the propane supply at the container.
from a neighbor’s phone. DO NOT go back in the building.
(psi) for • Call us minutes
High Pressure Method:
TP
(psi)
Start
(psi)
End
SP
(psi)
Start
(psi)
(“w.c.)
allergies
(System Pressure• Colds,
(SP) less
5 psi) and sinus congestion can all affect your sense of
smell.
End
Low Pressure Method:
Start
REMEMBER THIS ABOUT PROPANE’S ODOR:
• Some people are unable to detect the odorant in gas.
C-3
#OGL
Downstream of 1st Reg:
End
minutes
(psi) for • Tobacco
smoke or strong cooking odors can cover up other odors.
• The use of tobacco, alcohol or drugs may also affect your sense of
smell.
ER
BACK
(9”w.c. +/- 1/2” w.c.)
(“w.c.) for
Comments:
IF YOU RUN OUT OF GAS:
• Shut offminutes
the main supply valve at your tank(s). Learn where this
supply shut off valve is located by asking us.
• Shut off all appliance burners and pilot valves. Instructions should be
on or with the appliance.
• When gas service is restored, to avoid hazards, have us turn the
valves back on, light the pilots and check the controls.
• Be sure all appliances are checked.
REMEMBER:
“I certify that the above-noted leak check and associated
out-of-gas
• NEVER
tamper with your appliance and related equipment. All
procedures were completed as prescribed by the Company’s Out-Of-Gas
repairs must be done by our qualified service technicians.
procedures”
• If appliance control has been exposed to water — it must be
replaced by our service technician immediately.
• All gas appliances must be installed by qualified service technicians.
• DO NOT remove gas appliances, as all open gas lines must be
TEL. NUMBER
COMPANY NAME
plugged, capped or removed completely.
DRIVER вЃ„ TECH SIGNATURE
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO
PROPANE APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
CUSTOMER SIGNATURE
“My propane gas system has been successfully restarted
and I am satisfied with the services performed.”
Designed to fit Aluminum Meter Ticket Holders.
Top Quality Carbonless Stock.
#OGLC-3
41⁄4” X 115⁄8”
3-Ply NCR Stock
These Cost-Effective Forms Help Your
Service Staff Perform This Important Job.
500 Sets $ 50.00/lot
1000 Sets $ 90.00/lot
How to Close Gas Supply Valves
MARGINAL WORDS
Also available in cus tom
formats to mee t your
spe cif ic requireme nts.
TO ORDER CALL
800-221-1209
PROPANE MARKETPLACE - USEFUL PRODUCTS
37
PROPANE - THERMAL ROLL TICKETS
FORM #TSR4B
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
4 ⁄4” Wide, 330 ft., 1 ⁄4” core
Perfed every 81⁄2” with timing mark
“Duty to Warn” backer
Packaged 8 rolls/ctn.
Premium 20# paper stock to
ensure clear lasting image.
• Rolls are manufactured to exact
specs to ensure trouble free use in the field.
• Competitive prices lower your overhead.
1
  QTY.
1-6 ctn.
7-13 ctn.
14-20 ctn.
21-24 ctn.
25-38 ctn.
39-50 ctn.
51-63 ctn.
8-48 rolls
56-104 rolls
112-160 rolls
168-192 rolls
200-304 rolls
312-400 rolls
408-504 rolls
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
How To Close Gas Supply Valves
TURN
•
•
•
•
•
1
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
TSR4B
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
REORDER FORM # TSR4B FROM WEHOF FORMS (800) 221-1209
TSR4B.indd 1
3/2/11 2:39:54 PM
“DUTY TO WARN”
BACKER
PRICE
PER ROLL
$ 10.40/roll
$ 9.70/roll
$ 9.25/roll 
$ 8.95/roll
$ 8.30/roll
$ 7.20/roll
$ 6.80/roll
For highe r quant i t ie s, call for a quo te .
Blaster Printer
Cognitive Model
LBX42 - 2043
Advantage LX
Works with Automated
Wireless, K&K Computing,
TCS & Touchstar software
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
FUEL OIL - THERMAL ROLLS TICKETS
FORM #TSR4
#TSR4
Blaster Printer
Cognitive Model
LBX42 - 2043
Advantage LX
•
•
•
•
•
41⁄4” Wide, 345 ft., 11⁄4” core
Blank roll Perfed every 81⁄2” with timing mark
Packaged 8 rolls/ctn.
Premium 20# paper stock to ensure clear lasting image.
Rolls are manufactured to exact specs to ensure trouble
free use in the field.
• Competitive prices lower your overhead.
  QTY.
1-6 ctn.
7-13 ctn.
14-20 ctn.
21-24 ctn.
25-38 ctn.
39-50 ctn.
51-63 ctn.
8-48 rolls
56-104 rolls
112-160 rolls
168-192 rolls
200-304 rolls
312-400 rolls
408-504 rolls
PRICE
PER ROLL
$ 10.40/roll
$ 9.70/roll
$ 9.25/roll 
$ 8.95/roll
$ 8.30/roll
$ 7.20/roll
$ 6.80/roll
For highe r quant i t ie s, call for a quo te .
Works with Automated
Wireless, K&K Computing,
TCS & Touchstar software
www.FormsPro.net
38
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
CUSTOM THERMAL ROLL TICKETS
We can customize our high quality thermal rolls to suit your company’s
needs. We offer industry-specific back prints and special paper stocks to meet
rigid demands for banking and postal regulations. We have the expertise and
knowledge to supply you with the best roll products that the industry can buy.
THE OIL COMPANY IS RESPONSIBLE FOR THE
DELIVERY OF PRODUCT TO THE RECEIVING PIPE OR
OUTLET DESIGNATED BY THE CUSTOMER. CUSTOMER
AGREES THAT NEITHER THE OIL CO. NOR ITS
EMPLOYEES OR AGENTS, ARE OR SHALL BE LIABLE
UNDER ANY CIRCUMSTANCES FOR ANY DAMAGES
RESULTING FROM LEAKS OR FOR THE FAILURE OF
THE RECEIVING TANK OR ASSOCIATED PIPING OR
ANY OTHER MATTER.
LATE CHARGE COMPUTATION
A late payment FINANCE CHARGE of 11вЃ„2% per month
will be added on any balance 30 DAYS past due or 18%
ANNUALLY. The late charge is computed and accumulated
daily, based on the monthly rate divided by 30 days. The
late charge does not apply to items in dispute.
If any invoice is not paid within 30 days after rendering, I
agree to pay Skylands any and all collection costs
including but not limited to reasonable attorney’s fees and
costs.
If any invoice is not paid within 30 days of rendering, I agree
that Skylands shall have the right to interrupt or cease my
oil deliveries and service requirements and request.
IN CASE OF ERRORS OR INQUIRIES
ABOUT YOUR BILL
Send your inquiry in writing by registered or certified mail
on a separate sheet so that we receive it within 30 days
after the statement was mailed to you. Your written inquiry
must include:
1. Your name and account number (if any)
2. A description of the error and why (to the extent you
can explain) you believe it is an error and
3. The dollar amount of the suspected error.
Within 90 days we will mail a written notice stating that the
amount believed to be in error has been corrected or send
a written notice setting forth the reasons why we believe
the account was correctly shown in the statement. During
this time we may not take any action to collect disputed
amounts or report disputed amounts as delinquent. You
remain obligated to pay the parts of your bill not in dispute.
This is a summary of your rights; a full statement of your
rights and the creditor's responsibilities under the Federal
Fair Credit Billing Act will be sent to you both upon request
and in response to a billing error inquiry.
REORDER FROM WEHOF FORMS (800) 221-1209
Your
company
name &
logo
here!
Your
company
name &
logo
here!
DIGITAL DISPATCHER
BACKER
ENVELOPE
IMPORTANT: TERMS - NET 7 DAYS. 1ВЅ% interest
will be charged on all overdue invoices.
SERVICE CHARGE ON ALL SPECIAL DELIVERIES
FROM
*** CONDITIONS ***
The consumer to whom this delivery is made understands and agrees that cylinders and equipment (fittings, tubing, hood, etc.) are the property of Propane & Oil
Company, it's affiliates, subsidiaries, successors or assigned. Annual customer
purchases of propane less than 3 times tank capacity, may be subject to an
additional charge (minimum usage charge). Propane & Oil Company at all times
retains the right to enter upon premises at any or all reasonable hours of the day
for purposes of inspection or removal of cylinders and equipment without any
questions or hindrance on the part of the consumer.
SAFETY NOTICE
REORDER FROM WEHOF FORMS 1(800) 221-1209 www.formspro.net
For your safety, propane has an odor added so you can detect leaks. You and
each person using or handling propane in your household must know the smell of
propane. Ask for a scratch 'n sniff brochure or MSDS to demonstrate the odor. If
anyone is unable to recognize the odor of propane, call us immediately.
Bob's
OIL & PROPANE
Propane is heavier than air; therefore, leaks will initially tend to settle to floor ground
levels. To check for propane, carefully smell in low spots.
Under some of the following conditions, you may not be able to smell a gas leak.
For example:
P.O. Box 56
Hilltop, PA 38707-0658
670-464-6985
www.boboil&propane.com
Age, colds, allergies, sinus congestion or the use of tobacco, alcohol or
drugs may diminish your sense of smell.
Cooking or other strong odors may cover up the smell of gas.
In certain circumstances, propane gas may lose its distinctive smell - this
is called "ODORANT FADE".
Sometimes propane gas can lose its distinctive odor if a leak occurs
underground or if there is rust on the inside of the cylinder or piping.
Some persons are physically unable to detect the smell of gas. If you are
one of these people, call us immediately.
SERVICES
24/7
24 HOUR
DELIVERY
SERVICE
Bob's
OIL & PROPANE
PO BOX 56
HILLTOP PA 38707-0658
For these reasons, it is recommended that you purchase and install propane gas
detector(s) according to the manufacturer's instructions as a back-up warning
device. If anyone using or handling propane is unable to recognize the odor of propane, you should not use it until you have purchased and installed gas detector(s).
WHAT TO DO IF YOU SMELL GAS…
п‚© Petroleum
Products
Delivery
1. Put out all smoking materials and any other open flames.
2. DO NOT operate any appliances, switches, telephone, cigarette lighter,
appliance or thermostat. Any spark in the area where propane gas is
present may ignite the gas.
3. Get everyone out of the building immediately.
4. Shut off the gas supply at the tank or cylinder. (See below.)
п‚© Propane
Delivery
п‚© Heating & Air
Conditioning
Specialists
п‚© Water
Treatment
Systems
Installation
5. Call Propane & Oil Company - use your neighbor's telephone - if gas odor
is in the building.
6. Have your Propane & Oil Company service person locate and repair the leak.
Have your Propane & Oil Company service person air out the area and check and
re-light your gas appliance. Do not return to the building until you are advised
that all leaks have been repaired and it is safe to return.
п‚© Online Bill
Pay
WE ACCEPT:
PLEASE PUT
STAMP HERE
POST OFFICE WILL
NOT
DELIVER MAIL
WITHOUT
POSTAGE
Fuel Oil Disclaimer
Propane & Oil Company is responsible for the delivery of product to the receiving pipe
or outlet designated by the customer. Customer agrees that neither Propane & Oil
Company nor its employees or agents, are or shall be liable under any circumstances
for any damages resulting from leaks or for the failure of the receiving tank or associated
TERMS: NET 7 DAYS
piping or any other matter. In the event that the 00customer wishes to discontinue
$50. RETURN CHECK FEE
service, or wishes to change, remove or otherwise alter the receiving tank or any of the
associated piping, customer shall notify Propane & Oil Company in writing at least 10
(ten) days prior to such change. Customer agrees that its failure to notify shall relieve
RRAL
Propane & Oil Company of any liability resulting from their
that a) service
EFEassumptions
should be continued; or b) that any change, removal orRother alteration of the receiving
tank and associated piping has not been made.
REWARDS
CUSTOM SLIP
METER TICKET
Forms are 4” X 113⁄4” 3-Ply NCR Stock
w/Hard Back Copy; forms include a “Duty
to Warn” backer for the propane industry;
2000/carton. Custom printed in colors of
your choice.
Tickets with return envelopes and built in
door hangers are also available. 4 or 5 part
forms with NCR image inside envelope for
easier cash posting!
AMOUNT
RECEIVED
$
CUSTOMER
SIGNATURE
X
PLEASE PAY THIS AMOUNT
r
r
вћЎ
r NOT FULL
вћЎ
THIS IS
YOUR ONLY
INVOICE
CASH
CHECK
IMPORTANT SAFETY INFORMATION, PAYMENT TERMS & CONDITIONS ON BACK
CUSTOMER COPY
TO ORDER CALL
800-221-1209
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
DIGITAL DISPATCHER
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STOCK SLIP METER TICKET
FORM #LC3PB
Safety Notice
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Forms are 4” X 113⁄4” 3-Ply NCR Stock
w/Hard Back Copy; forms include a “Duty to
Warn” backer for the propane industry;
2000/carton.
IF YOU DETECT AN ODOR:
• Open windows and doors to increase ventilation.
• DO NOT light matches or cigarettes.
• DO NOT operate switches, electrical appliances, thermostats or
telephones. They may cause a spark to ignite escaping gas.
• Check to be sure all pilots are burning.
• If the source has not been detected, get everyone out of the
building and shut off the propane supply at the container.
• Call us from a neighborʼs phone. DO NOT go back in the building.
REMEMBER THIS ABOUT PROPANEКјS ODOR:
• Some people are unable to detect the odorant in gas.
• Colds, allergies and sinus congestion can all affect your sense of
smell.
• Tobacco smoke or strong cooking odors can cover up other odors.
• The use of tobacco, alcohol or drugs may also affect your sense of
smell.
NCR
4” X 113⁄4”
IF YOU RUN OUT OF GAS:
• Shut off the main supply valve at your tank(s). Learn where this
supply shut off valve is located by asking us.
• Shut off all appliance burners and pilot valves. Instructions should be
on or with the appliance.
• When gas service is restored, to avoid hazards, have us turn the
valves back on, light the pilots and check the controls.
• Be sure all appliances are checked.
REMEMBER:
• NEVER tamper with your appliance and related equipment. All
repairs must be done by our qualified service technicians.
• If appliance control has been exposed to water — it must be
replaced by our service technician immediately.
• All gas appliances must be installed by qualified service technicians.
• DO NOT remove gas appliances, as all open gas lines must be
plugged, capped or removed completely.
BE SURE EVERYONE WHO WILL BE IN REGULAR PROXIMITY TO
PROPANE APPLIANCES IS FAMILIAR WITH THIS INFORMATION.
How to Close Gas Supply Valves
WE ALSO HAVE SLIP TICKETS W/O BACKER
   QTY.
PRICE
1 ctn.    2000    $ 180.00
2 ctn.  4000    $ 348.00
3 ctn. 6000
$ 504.00
4 ctn. 8000
$ 648.00
5 ctn. 10000
$ 780.00
PRICE
PER 1,000
$ 90.00
$ 87.00
$ 84.00
$ 81.00
$ 78.00
01001
FITS EPSON PRINTER MODEL-TM T88V
FORM #DD3 ROLL TICKET
31⁄8”Wide, 170ft., 5⁄8” core, Thermal Roll Stock form
includes a “Oil Fill Pipe Disclaimer” backer for
the oil industry;
25/carton.
QTY.
PRICE
PER ROLL
1-5 boxes
$ 4.00
6-9 boxes $ 3.60
10+ boxes   $ 3.25
Company is responsible for the delivery of product to the receiving pipe
or outlet designated by the customer. Customer agrees that neither
Company nor its employees or agents, are or shall be liable under any
circumstances for any damages resulting from leaks or for the failure of
the receiving tank or associated piping or any other matter. In the event
that the customer wishes to discontinue service, or wishes to change,
remove or otherwise alter the receiving tank or any of the associated
piping, customer shall notify Company in writing at least 10 (ten) days
prior to such change. Customer agrees that its failure to notify shall relieve
Company of any liability resulting from their assumptions that a) service
should be continued; or b) that any change, removal or other alteration
of the receiving tank and associated piping has not been made.
 
PRICE
PER BOX
  $100.00/box    
$ 90.00/box 
$ 81.25/box
IMPORTANT INFORMATION ON PROPANE SAFETY
WARNING STATEMENT: Propane is an extremely flammable
gas. Propane vapor reduces oxygen available for breathing and
may cause suffocation in confined spaces. Propane liquid may
cause freeze burn similar to frostbite. Propane can contain small
quantities of chemicals known to cause cancer or birth defects.
FOR YOUR SAFETY, PROPANE HAS AN ODOR ADDED SO YOU
CAN DETECT LEAKS . . . You and each member of your family must
know the smell of propane. Ask your serviceman or deliveryman
to demonstrate its odor. If anyone in your household cannot smell
propane, or it smells weak, call us immediately. Propane is heavier
than air and will collect at floor level. Carefully smell at floor level and
in low spots to check for propane.
  
WHAT TO DO IF YOU SMELL GAS OR SUSPECT A LEAK:
1. Put out all smoking materials and any other open flames.
2. Do not operate any appliances, switches or thermostats.
3. Get everyone outside and away from gas equipment.
4. Shut off the gas supply, using the shut-off valve at the tank
or cylinder.
5. Call your propane supplier - use your neighbor’s phone - if gas
smell is in the house.
6. Stay outside and leave the gas off until the leak has been
found and fixed.
How To Close Gas Supply Valves
TURN
l
PROPERTIES OF PROPANE GAS:
• Propane is a flammable gas that can cause fires and explosions.
• Propane is heavier than air and can collect in low places (along
the floor, in basements, etc.)
• Propane has been odorized so you can smell it.
Shut-off
valve here
Shut-off
valve here
HOW TO CLOSE GAS
SUPPLY VALVES:
If you are unsure and/or
your installation does not
look like this diagram, call
us at the telephone number listed on the front of
this delivery invoice.
RELIGHTING YOUR PILOTS.
31⁄8”Wide, 170ft., 5⁄8” core, Thermal Roll Stock
form includes a “Duty to Warn” backer for
the propane industry;
25/carton.
www.FormsPro.net
RE-ORDER FORM # VTR4B AVAILABLE FROM WEHOF FORMS
FORM #DD3B ROLL TICKET
We strongly recommend that for safety reasons, you call a qualified
technician to relight your pilots. However, if you relight the pilots
yourself:
a. Turn all appliance controls and manual shut-off valves to the
OFF position.
b. Slowly open the tank shut-off valve.
c. Carefully smell for the presence of propane at floor level and
low spots before attempting to relight the pilot.
d. If gas is detected - STOP - See “WHAT TO DO IF YOU SMELL
GAS” above.
e. Follow the manufacturer’s instructions for pilot lighting.
YOUR PROPANE SYSTEM AND APPLIANCES HAVE BUILTIN SAFETY FEATURES . . .to help keep them working:
a. Do not allow unqualified personnel to service your propane
system or appliance.
b. Do not tamper with gas controls on appliances.
c. Do not let your system run out of propane.
d. Have wet or flooded appliances and controls serviced
immediately.
e. Understand that propane odor can fade or be covered up by other
strong odors.
f. Do not light pilot light in areas where there are strong odors completely ventilate the area first.
g. Call a qualified technician to relight pilots or carefully follow
the equipment manufacturer’s instructions.
h. Repeated pilot outages could indicate a hazardous condition
. . . Do not attempt to relight the pilot, call your serviceman.
39
40 OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
DRM METER TICKETS
INC.
DRM has been providing flexible, easy to use, Fuel Delivery software since 1983.
DRM’s customers depend on them to provide prompt, and patient support. With
Wehof Forms’ tickets in your trucks and office and DRM’s software systems, you
will present your customers with a detailed, exact accounting of the delivery. For 30
years Wehof Forms has been supplying high quality, stock and custom printed forms
for the DRM system. Strongly reinforce your company’s brand and its dedication
to customer service by getting your tickets and forms from Wehof Forms on your
next order.
$
$
TOTAL
TAX
$
CASH
CHECK
AMOUNT
$
PAYMENT RECEIVED
$
PRICE
GALLONS
в—Џ
REORDER FORM DRM3-NCR FROM WEHOF FORMS 1(800) 221-1209
TRUCK #
DEL. TIME
T
O
PRODUCT
D
E
L
#DRM
DRIVER
в—Џ
в—Џ
CR
-3-N
в—Џ
DATE
в—Џ
B
I
L
L
T
O
CERTIFIED METER READING
в—Џ
в—Џ
в—Џ
IN TANK AFTER
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
carbon or carbonless
same price!
$
$
TOTAL
TAX
$
CASH
CHECK
AMOUNT
$
PAYMENT RECEIVED
REORDER FORM 3C WEHOF FORMS 1(800) 221-1209
PRICE
GALLONS
$
$
$
$
TOTAL
TAX
DATE
GALLONS
в—Џ
в—Џ
CASH
CHECK
AMOUNT
$
#4-E
PRICE
в—Џ
в—Џ
в—Џ
в—Џ
PAYMENT RECEIVED
в—Џ
DRIVER
в—Џ
PRODUCT
DATE
IN TANK AFTER
в—Џ
DEL. TIME
в—Џ
TRUCK #
в—Џ
в—Џ
в—Џ
01001
CERTIFIED METER READING
в—Џ
в—Џ
в—Џ
01234
#SI-3
$
TRUCK #
DEL. TIME
в—Џ
в—Џ
WEHOF FORMS 800-221-1209 FORM 4-E
в—Џ
PRODUCT
в—Џ
&
#3-C R
C
N
C
#3
CERTIFIED METER READING
в—Џ
DRIVER
в—Џ
в—Џ
в—Џ
IN TANK AFTER
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
FORMS
#DRM-3-NCR*, 3-C* &
3C-NCR
91⁄2” X 4”; Universal Meter Ticket;
3-Ply with Hard Back Copy on
Ply-3; 2000/carton
PRICES: #DRM-3* & #3-C*   QTY.
1 ctn.    2000
2 ctn.  4000
3 ctn. 6000
4 ctn. 8000
PRICE
$ 132.00
 $ 252.00
 $ 360.00
 $ 464.00
PRICE
PER 1,000
$ 66.00
$ 63.00
$ 60.00
$ 58.00
FORMS #4-E*
91⁄2” X 4”, Universal Meter Ticket
3-Ply Plus Envelope
NCR; 1200/carton
1-2 ctns. $ 130.00/M
3 & Up ctns.$ 125.00/M
FORM #SI-3*
91⁄2” X 51⁄2”; Service Invoice
3-Ply; NCR; 1200/carton
1 ctn.
2 ctn.
3 ctn.
1,200
2,400
3,600
$ 66.00/M
$ 64.00/M
$ 62.00/M
*Imprinting available to customize with logos, etc.
TO ORDER CALL
800-221-1209
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
We
sa
you ve
$
Ask …
howus
!
41
DRM STATEMENTS/INVOICES
FOR PAYMENT DUE
FORM #DRMBC-1
Laser Budget Coupon Sheet
81⁄2” X 11”; 1-Ply White 24#
Laser Bond; 1000/carton
$ 110.00/M $ 110.00/ctn.
FOR PAYMENT DUE
BC-1
#DRM
ACCOUNT NUMBER
AMOUNT DUE
FOR PAYMENT DUE
FOR PAYMENT DUE
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
ACCOUNT NUMBER
AMOUNT DUE
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
DATE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
S
I
T
E
I
L
L
T
O
ACCOUNT NUMBER
AMOUNT DUE
в–ј TEAR HERE
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
B
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
81⁄2” X 11”; 1-Ply Laser Statements/
Invoices; Premium White
24# Laser Bond;
2500/carton
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
AMOUNT ENCLOSED $
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PRICE
PER 1,000
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
M-1
#LDR
$ 26.00
$ 25.00
$ 24.00
$ 23.00
REORDER FORM # LDRM-1 FROM WEHOF FORMS 800-221-1209
  QTY.
PRICE
1 ctn.  2500    $ 65.00
2 ctn.  5000   $ 125.00
3 ctn. 7500
$ 180.00
4 ctn. 10000
$ 230.00
FOR PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
FORM #LDRM-1
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
FORM #MLDWE
Double Window Envelope for Laser
Invoice/Statements; Blank 24#; White
Wove; 2500/ctn.
  QTY.
PRICE
1 ctn.  2500    $ 110.00
2 ctn.  5000   $ 210.00
3 ctn. 7500
$ 307.50
4 ctn. 10000
$ 400.00
WE
#MLD
PRICE
PER 1,000
$ 44.00
$ 42.00
$ 41.00
$ 40.00
FORM #BUDGET ENVELOPE
в—Џ
REORDER FORM #BUDGET ENELOPE FROM WEHOF FORMS 800-221-1209
9” X 32⁄3”; 2-ply 20# Bond
3000/carton
в—Џ
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    3000 $ 126.00 $ 42.00
2 ctn.  6000  $ 246.00 $ 41.00
3 ctn. 9000  $ 360.00 $ 40.00
4 ctn. 12000  $ 468.00 $ 39.00
F
R
O
M
в—Џ
в—Џ
в—Џ
вћЅ
M
A
I
L
в—Џ OT
PLEASE PAY
THIS AMOUNT
PLEASE PAY
THIS AMOUNT
PAYMENT DUE
PAYMENT DUE
ACCOUNT NO.
ACCOUNT NO.
в—Џ
в—Џ
GET
#BUD PE
LO
ENVE
вћЅ
RETAIN THIS
STUB FOR
YOUR RECORDS
в—Џ
в—Џ
в—Џ
AMOUNT PAID $
в—Џ
CHECK NO.
в—Џ
DATE MAILED
DETACH TOP COPY ONLY AT PERFORATION
Quick De li ver y!
www.FormsPro.net
в—Џ
42
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
*Imprinting available to customize
with logos, etc.
CNC SOFTWARE FORMS
STATEMENTS
в—Џ
в—Џ
в—Џ
PHONE
DATE
LOW
S
PRICE
в—Џ
в—Џ
в—Џ
в—Џ
FORM #CNCST-1*
в—Џ
в—Џ
в—Џ
в—Џ
ACCOUNT NO.
AMOUNT
ENCLOSED
в—Џ
в—Џ
TERMS: NET
в—Џ
DAYS FROM INVOICE DATE
в—Џ
TEAR OFF AT PERFORATION AND RETURN WITH PAYMENT
в—Џ
DATE
INVOICE NO.
CHARGES AND CREDITS
в—Џ
AMOUNT
в—Џ
в—Џ
ST-1
#CNC
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
PHONE
CLS-7
#CN
в—Џ
в—Џ
TEAR OFF AT PERFORATION AND RETURN WITH PAYMENT
DATE
в—Џ
INVOICE NO.
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
DATE
ACCOUNT NO.
в—Џ
AMOUNT
ENCLOSED
в—Џ
AMOUNT
DUE
в—Џ
ACCOUNT NO.
в—Џ
TERMS: NET
DAYS FROM INVOICE DATE
AMOUNT
CHARGES AND CREDITS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
REORDER FORM #CNCLS7 FROM WEHOF FORMS 800-221-1209
REORDER FORM CNCST-1 FROM WEHOF FORMS 800-221-1209
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
AMOUNT
DUE
ACCOUNT NO.
в—Џ
вћ§
в—Џ
.
в—Џ
в—Џ
PHONE
DATE
AMOUNT
ENCLOSED
TERMS: NET
DAYS FROM INVOICE DATE
TEAR OFF AT PERFORATION AND RETURN WITH PAYMENT
INVOICE NO.
DESCRIPTION
AMOUNT
BALANCE
-L1
#CNC
NON BUDGET
AMOUNT DUE
ACCOUNT NO.
FORM #CNCLS-7*
91⁄2” X 7” Statement; 1-Ply White 24# Bond;
PRICE
2500/carton
  QTY.
PRICE
PER 1,000
1 ctn.  2500    $ 65.00
$ 26.00
2 ctn.  5000   $ 125.00
$ 25.00
3 ctn. 7500
$ 180.00
$ 24.00
4 ctn. 10000
$ 230.00
$ 23.00
FORM #CNC-L1
ACCOUNT NO.
DATE
91⁄2” X 11” Statement; 1-Ply; White 20# Bond;
PRICE
2500/carton
  QTY.
PRICE
PER 1,000
1 ctn.  2500    $ 85.00
$ 34.00
2 ctn.  5000   $ 160.00
$ 32.00
3 ctn. 7500
$ 225.00
$ 30.00
4 ctn. 10000
$ 290.00
$ 29.00
BUDGET
AMOUNT DUE
TOTAL
AMOUNT DUE
81⁄2” X 11” Laser Statement; 1-Ply; White
24# Bond; 2500/carton
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.  2500    $ 65.00
$ 26.00
2 ctn.  5000   $ 125.00
$ 25.00
3 ctn. 7500
$ 180.00
$ 24.00
4 ctn. 10000
$ 230.00
$ 23.00
FORM #DWE
Double Window Envelope; Blank 24# White
Wove 2500/ctn. - fits Form CNCLS7
FORM #MLDWE
#DWE
WE
#MLD
Double Window Envelope for Laser Invoice/
Statements; Blank 24#; White
Wove; 2500/ctn.
Prices for FORMs #DWE & #MLDWE
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.  2500    $ 110.00
$ 44.00
2 ctn.  5000   $ 210.00
$ 42.00
3 ctn. 7500
$ 307.50
$ 41.00
4 ctn. 10000
$ 400.00
$ 40.00
TO ORDER CALL 800-221-1209
43
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
CNC SOFTWARE FORMS
METER TICKETS
01001
в—Џ
TANK
в—Џ
в—Џ
ACCOUNT NO.
в—Џ
PAY DISCOUNT AMOUNT
DRIVER
TIME
OF DEL.
CASH
THIS IS YOUR INVOICE
CHARGE
в—Џ
в—Џ
D
E
I
L
N
I
S
V
T
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R.
R
Y
в—Џ
в—Џ
D.D. NEXT
ZONE
TANK
01001
CALL
LOCATION
ACCOUNT NO.
3T
#CNC
GALLONS
FULL PRICE PER GALLON
PAY DISCOUNT AMOUNT
AFTER
TRUCK
DAYS
TAX
DRIVER
TIME
OF DEL.
THIS IS YOUR INVOICE
в—Џ
REORDER FORM #BUDGET ENELOPE FROM WEHOF FORMS 800-221-1209
в—Џ
в—Џ
CHECK
CHARGE
PAYMENT RECEIVED
CUSTOMER SIGNATURE
We
sa
you ve
$
Ask …
u
how s
!
F
R
O
M
в—Џ
в—Џ
в—Џ
AM
PM
CASH
вћЅ
M
A
I
L
в—Џ OT
PLEASE PAY
THIS AMOUNT
PLEASE PAY
THIS AMOUNT
PAYMENT DUE
PAYMENT DUE
ACCOUNT NO.
ACCOUNT NO.
TENTHS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
DISCOUNT PRICE PER GALLON
PAY THIS AMOUNT
в—Џ
в—Џ
ORDER DATE
DELIVERY DATE
FORM #BUDGET ENVELOPE
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    3000 $ 126.00 $ 42.00
2 ctn.  6000  $ 246.00 $ 41.00
3 ctn. 9000  $ 360.00 $ 40.00
4 ctn. 12000  $ 468.00 $ 39.00
CUSTOMER SIGNATURE
в—Џ
REORDER FORM #CNC3T FROM WEHOF FORMS 800-221-1209
D
E
LT
I O
V
E
R
DAYS
CERTIFIED METER READING
FUEL
в—Џ
PAY THIS AMOUNT
PAYMENT RECEIVED
в—Џ
Compare our pr ice s!
9” X 32⁄3”; 2-ply 20# Bond
3000/carton
AM
PM
CHECK
AFTER
TAX
TENTHS
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 132.00 $ 66.00
2 ctn.  4000  $ 252.00 $ 63.00
3 ctn. 6000  $ 360.00 $ 60.00
4 ctn. 8000  $ 464.00 $ 58.00
DISCOUNT PRICE PER GALLON
TRUCK
в—Џ
в—Џ
DELIVERY DATE
GALLONS
3B
в—Џ
ORDER DATE
FULL PRICE PER GALLON
#CNC
D
E
I
L
N
I
S
V
T
E
R.
R
Y
в—Џ
в—Џ
CALL
LOCATION
TENTHS
ZONE
TENTHS
D.D. NEXT
D
E
LT
I O
V
E
R
CERTIFIED METER READING
91⁄2” X 4” Meter Ticket 3-Ply
NCR Carbonless Stock
2000/carton
FUEL
в—Џ
REORDER FORM #CNC3B FROM WEHOF FORMS 800-221-1209
FORMS #CNC3B-NCR* &
#CNC3T-NCR*
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
GET
#BUD PE
LO
ENVE
RETAIN THIS
STUB FOR
YOUR RECORDS
в—Џ
в—Џ
в—Џ
AMOUNT PAID $
вћЅ
в—Џ
CHECK NO.
в—Џ
DATE MAILED
DETACH TOP COPY ONLY AT PERFORATION
в—Џ
FORM #SI-3*
91⁄2” X 51⁄2”
Service Invoice; 3-Ply
NCR Carbonless Stock
1200/carton
All parts glued on left side.
1 ctn. 1,200 $ 66.00/M
2 ctn. 2,400 $ 64.00/M
3 ctn. 3,600 $ 62.00/M
#SI-3
*Imprinting available to customize with logos, etc.
www.FormsPro.net
44 OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
MARKET LINE STOCK FORMS
DATE
INVOICE #
FORM #MLI
INVOICE
81⁄2” X 11”
1-Ply Laser Invoices
Premium White 24# Laser Bond
2500/carton
PRICE
PAYABLE UPON RECEIPT
PLEASE INSERT AMOUNT PAID
$_____________
BILL TO ACCOUNT #:
TEAR ON DOTTED LINE AND RETURN TOP PORTION WITH YOUR PAYMENT
в—†
в—†
DATE
DESCRIPTION
  QTY.
1 ctn.    2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
AMOUNT
#MLI
Compare
our pr ice s!
days or over we will compute a
% PER MONTH, WHICH IS
PAY THIS AMOUNT
% ANNUAL PERCENTAGE RATE.
в–ј
On balances of
FINANCE CHARGE OF
PRICE
PER 1,000
$ 65.00
 $ 125.00
 $ 180.00
 $ 230.00
$ 26.00
$ 25.00
$ 24.00
$ 23.00
We save
you $…
Ask us
how!
FORM #MLS
81⁄2” X 11”
1-Ply Laser Statements
Premium White 24# Laser Bond
2500/carton
PRICE
#MLS
Payments received after this date
will appear on next month’s billing.
  QTY.
1 ctn.    2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
MONTHLY BUDGET
SUMMARY
PRICE
$ 65.00
 $ 125.00
 $ 180.00
 $ 230.00
PER 1,000
$ 26.00
$ 25.00
$ 24.00
$ 23.00
PLEASE INSERT AMOUNT PAID
$_____________
BILL TO ACCOUNT #:
FORM #MLBS
TEAR ON DOTTED LINE AND RETURN TOP PORTION WITH YOUR PAYMENT
в—†
в—†
DATE
PAST DUE
REFERENCE
QUANTITY
NON-BUDGET
DESCRIPTION
TOTAL DUE
CHARGES
CREDITS
S
#MLB
RUNNING ACCOUNT BALANCE
RUNNING ACCOUNT
BALANCE
BUDGET AMOUNTS
PAY THIS AMOUNT
в–ј
CURRENT
PREVIOUS BALANCE
AMOUNT
81⁄2” X 11”
1-Ply Laser Budget Summary
Premium White 24# Laser Bond
2500/carton
PRICE
  QTY.
1 ctn.    2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
TO ORDER CALL
PRICE
$ 65.00
 $ 125.00
 $ 180.00
 $ 230.00
800-221-1209
PER 1,000
$ 26.00
$ 25.00
$ 24.00
$ 23.00
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
45
MARKET LINE STOCK FORMS
DD NEXT
DLV STA PROD
DD INTVL
ACCOUNT NO.
ACCOUNT NO.
PRODUCT
DATE
GALLONS
PRICE/GAL
AMOUNT
в—Џ
D D NEXT
DATE
USEABLE
RUNOUT
TANK SIZE
DLV ST
GALS
FULL
TAX
FILL LOCATION
DLV ZONE
CURR. K
DD
ACCT ST
PROJ
KFAC
в—Џ
PZ
DRIVER
TRUCK
#MMT
T
O
T
A
L
CERTIFIED METER READING
в—Џ
TANK SIZE
IN TANK AFTER
BILL TO:
в—Џ
PAYMENT REC’D
CASH
CHECK
CUSTOMER SIGNATURE
$
X
в—Џ
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 160.00 $ 80.00
2 ctn.  4000  $ 312.00 $ 78.00
3 ctn. 6000  $ 456.00 $ 76.00
4 ctn. 8000  $ 592.00 $ 74.00
LAST DIGIT DENOTES 1/10th GALLONS
в—Џ
DLV. ZONE
DLV. ST
TANK SIZE
TAX
ACCT. ST
FILL LOCATION
PROJ
GALLONS
PRICE/GAL
AMOUNT
DLV ZONE
PZ
TRUCK
DRIVER
IN TANK AFTER
BILL TO:
$
T
O
T
A
L
PAYMENT REC'D
CASH
CHECK
CUSTOMER SIGNATURE
CERTIFIED METER READING LAST DIGIT DENOTES 1/10th GALLONS
D D NEXT
DATE
3
#MMT
01001
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 132.00 $ 66.00
2 ctn.  4000  $ 252.00 $ 63.00
3 ctn. 6000  $ 360.00 $ 60.00
4 ctn. 8000  $ 464.00 $ 58.00
Compare
our pr ice s!
FORM #MLDWE
Double Window Envelope for Laser
Invoice/Statements; Blank 24#; White
Wove; 2500/ctn.
PRICE
PER 1,000
$ 44.00
$ 42.00
$ 41.00
$ 40.00
в—Џ
  QTY.
1 ctn.    3000
2 ctn.  6000
3 ctn. 9000
4 ctn. 12000
PRICE
$ 126.00
 $ 246.00
 $ 360.00
 $ 468.00
PER 1,000
$ 42.00
$ 41.00
$ 40.00
$ 39.00
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
FROM:
REORDER FORM #MLBE FROM WEHOF FORMS 800-221-1209
Market Line Budget Envelope 81⁄2” X 4”;
2-ply
20# bond; 3000/carton PRICE
в—Џ
PLEASE PAY
THIS AMOUNT
PLEASE PAY
THIS AMOUNT
PAYMENT DUE
PAYMENT DUE
в—Џ
в—Џ
FIRST-CLASS MAIL TO:
MLBE
#
PLEASE REMOVE THIS STUB BEFORE MAILING
FORM #MLBE
WE
#MLD
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
*Imprinting available to
customize with logos, etc.
www.FormsPro.net
REORDER FORM #MMT3 FROM WEHOF FORMS 1(800) 221-1209
9 ⁄2” X 4”
3-ply NCR Meter Ticket with Hard Back
Copy and Oil Fill Pipe Disclaimer Backer
2000/carton
PRODUCT
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
01001
CERTIFIED METER READING LAST DIGIT DENOTES 1/10th GALLONS
ACCOUNT NO
1
  QTY.
PRICE
1 ctn.  2500    $ 110.00
2 ctn.  5000   $ 210.00
3 ctn. 7500
$ 307.50
4 ctn. 10000
$ 400.00
в—Џ
e
We sav
you $…
Ask us
how!
FORM #MMT3*
в—Џ
REORDER FORM # MMT WEHOF FORMS 1(800) 221-1209
121⁄2” X 4”
3-ply NCR Meter Ticket with
Hard Back Copy and Oil Fill Pipe
Disclaimer Backer; 2000/carton
в—Џ
LAST DIGIT DENOTES 1/10th GALLONS
в—Џ
CERTIFIED METER READING
FORM #MMT*
46
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
MICRO ANALYST ASSOC.
FORM #MAA-3MT*
PROJ. D.D.
AMOUNT
PRICE
$
в—Џ
T
-3M
#MAA
TIME
в—Џ
PAYMENT RECEIVED
в—Џ
$
$
вќ’ CASH
TOTAL
$
вќ’ CHECK
TRUCK #
вќ’ AM DRIVER
вќ’ PM
CERTIFIED METER READING
в—Џ
в—Џ
в—Џ
DATE
в—Џ
REORDER MA–3MT FROM WEHOF FORMS 1(800) 221-1209
TANK SIZE
GALLONS
CODE
PRODUCT
ACCOUNT NO.
IN TANK AFTER
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
91⁄2” X 4” Meter Ticket 3-Ply
NCR Carbonless Stock & Hard Back
Copy on Ply 3; 2000/ctn.
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 132.00 $ 66.00
2 ctn.  4000  $ 252.00 $ 63.00
3 ctn. 6000  $ 360.00 $ 60.00
4 ctn. 8000  $ 464.00 $ 58.00
FORM #MAA-L1
PAGE
DATE
81⁄2” X 11” Micro Analyst
Multi-Purpose Laser Form
1-ply Statement/Invoice
Premium White 24# Laser Bond
PRICE
2500/ctn.
ACCOUNT #
-L1
#MAA
  QTY.
1 ctn.    2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
PLEASE RETURN THIS STUB WITH PAYMENT.
MULTI-PURPOSE
LASER FORM
PRICE
$ 65.00
 $ 125.00
 $ 180.00
 $ 230.00
PER 1,000
$ 26.00
$ 25.00
$ 24.00
$ 23.00
FORM #MLDWE
Double Window Envelope for Laser
Invoice/Statements; Blank 24#; White
Wove; 2500/ctn.
WE
  QTY.
PRICE
1 ctn.  2500    $ 110.00
2 ctn.  5000   $ 210.00
3 ctn. 7500
$ 307.50
4 ctn. 10000
$ 400.00
#MLD
PRICE
PER 1,000
$ 44.00
$ 42.00
$ 41.00
$ 40.00
FORM #BUDGET ENVELOPE
REORDER FORM #BUDGET ENELOPE FROM WEHOF FORMS 800-221-1209
в—Џ
в—Џ
F
R
O
M
в—Џ
в—Џ
в—Џ
вћЅ
M
A
I
L
в—Џ OT
PLEASE PAY
THIS AMOUNT
GET
#BUD PE
O
L
E
ENV
в—Џ
PLEASE PAY
THIS AMOUNT
в—Џ
PAYMENT DUE
PAYMENT DUE
ACCOUNT NO.
ACCOUNT NO.
RETAIN THIS
STUB FOR
YOUR RECORDS
в—Џ
в—Џ
AMOUNT PAID $
вћЅ
в—Џ
в—Џ
CHECK NO.
в—Џ
DATE MAILED
DETACH TOP COPY ONLY AT PERFORATION
*Imprinting available
to customize with
logos, etc.
в—Џ
9” X 32⁄3”; 2-ply 20# Bond
3000/carton
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    3000 $ 126.00 $ 42.00
2 ctn.  6000  $ 246.00 $ 41.00
3 ctn. 9000  $ 360.00 $ 40.00
4 ctn. 12000  $ 468.00 $ 39.00
TO ORDER CALL
800-221-1209
47
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
MAA - CUSTOM FORMS
MAILER
Meter Tickets, Mailers, Statements,
and Invoices, all designed for MAA
systems and to match your corporate
image.
A/P CHECK
15549
в„ў
PREMIUM HEATING OIL
в„ў
4 HAMPTON ST. • P.O. BOX 591
NEWTON, NJ 07860
(973) 383-1421
www.hartandiliff.com
PREMIUM HEATING OIL
15549
SUSSEX BANK
NEWTON, NJ
55-624/212
DATE
FUEL OIL BUDGET PAYMENT PLAN
AMOUNT
PAY
TO THE
ORDER
OF
YOUR FUEL OIL PAYMENT PLAN HAS BEEN BASED ON
ESTIMATED GALLONS REQUIRED FOR THE COMING HEATING
SEASON, UNDER NORMAL WEATHER CONDITIONS AND
CURRENT PRICES. SERVICE AND CONTRACT CHARGES MUST
BE PAID SEPARATELY AS INCURRED. OLD BALANCES IF ANY
MUST BE PAID PRIOR TO 1st. BUDGET PAYMENT.
PO Box 7084 Wantagh NY 11793-2204
MP
BILL TO ACCOUNT #:
PMT. AMOUNT
FIRST PMT. DUE
NO. OF PMTS.
NOTE:
CONVENIENT PAYMENT AND DELIVERY
RECORD ON REVERSE SIDE.
15549
в„ў
PREMIUM HEATING OIL
HERE ARE YOUR NEW COUPONS & PAYMENT SCHEDULE.
***NON-BUDGETS, SIMPLY REMIT YOUR FIRST PAYMENT WITH COUPON - WE WILL PUT YOU ON BUDGET. THANK
YOU.
BUDGET
PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
AMOUNT DUE
FOR PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
BUDGET
COUPON
AMOUNT DUE
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
REORDER CALL WEHOF FORMS 1-800-221-1209
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
AMOUNT DUE
FOR PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
ACCOUNT NUMBER
PAGE
Federal Heating FOR
& Engineering
Co.,
Inc.DUE
PAYMENT DUE
AMOUNT
AMOUNT DUE
160 Cross Street, Winchester, MA 01890
781-721-2468 • 978-474-4567
www.federalheat.com
DATE
– SINCE 1951 –
ACCOUNT #
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
DETACH
AND MAIL
WITH
YOUR PAYMENT
FUEL OIL •PLEASE
HEATING
SYSTEMS
• AIR
CONDITIONING
A/P CHECK
BUDGET
PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
FOR PAYMENT DUE
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET
PAYMENT
BUDGET
PAYMENT
ACCOUNT NUMBER
FOR PAYMENT DUE
AMOUNT DUE
FOR PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
R
LASE
M
R
FO
ACCOUNT NUMBER
AMOUNT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE RETURN THIS STUB WITH PAYMENT.
в—Џ
WEHOF FORMS • 800-221-1209
в—Џ
statement
в—Џ
в—Џ
SALES – SE RV I C E – IN S TA L LAT I O N S
868 39th ST R E E T B RO O K LY N, NY 11232
T E L: 718-435-2200 • FA X: 718-435-3096
в—Џ
STATEMENT DATE
P.O. Box 520
STATEMENT DATE
ACCOUNT NO.
Winchester,
MA 01890-0720
в—Џ
в—Џ
FEDERAL HEATING-LASER ST-reflex.indd
в—Џ
вќЏ
в—Џ
DATE PAID
DATE
GALLONS
в—Џ
NT
EME
STAT
CHECK NO.
INVOICE NO.
AMOUNT PD.
DESCRIPTION
AMOUNT
BALANCE
в—Џ
$
в—Џ
AMOUNT REMITTED
DATE
AMOUNT
вњ“
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
CURRENT
OVER 30 DAYS
OVER 60 DAYS
OVER 90 DAYS
OVER 120 DAYS
TOTAL DUE
PLEASE PAY THIS AMOUNT
TOTAL вћЎ
в—Џ
в—Џ
LASER FORM
METER TICKET
www.FormsPro.net
CHECK HERE FOR:
(SEE REVERSE SIDE)
в—Џ
1
TO:
в—Џ
в—Џ
в—Џ
Remit to: Federal Heating
ACCOUNT NO.
6/19/09
8:20:17 AM
48
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
UNITED DATA SYSTEMS
United Data Systems Inc.
FORM #BUDGET ENVELOPE
REORDER FORM #BUDGET ENELOPE FROM WEHOF FORMS 800-221-1209
в—Џ
в—Џ
F
R
O
M
PLEASE PAY
THIS AMOUNT
в—Џ
GET
#BUD PE
O
L
ENVE
в—Џ
в—Џ
в—Џ
в—Џ
PLEASE PAY
THIS AMOUNT
вћЅ
M
A
I
L
в—Џ OT
PAYMENT DUE
PAYMENT DUE
ACCOUNT NO.
ACCOUNT NO.
RETAIN THIS
STUB FOR
YOUR RECORDS
в—Џ
в—Џ
в—Џ
AMOUNT PAID $
вћЅ
в—Џ
CHECK NO.
в—Џ
DATE MAILED
DETACH TOP COPY ONLY AT PERFORATION
в—Џ
9” X 32⁄3”; 2-ply 20# Bond
3000/carton
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    3000 $ 126.00 $ 42.00
2 ctn.  6000  $ 246.00 $ 41.00
3 ctn. 9000  $ 360.00 $ 40.00
4 ctn. 12000  $ 468.00 $ 39.00
FORM #UDWE
Double Window Envelope
71⁄2” X 37⁄8”
24# White Wove
2500/carton
1 ctn. 2,500 $ 48.00/M
2 ctn. 5,000 $ 47.00/M
3 ctn. 7,500 $ 46.00/M
4 ctn. 10,000 $ 45.00/M
E
#UDW
END OF MONTH
STATEMENT
1111 CALHOUN AVENUE, BRONX, NY 10465
718.239.WARM (9276)
wWW.Newage fuel OIL.com
ACCOUNT NUMBER
BILLED TO:
PAYMENTS RECEIVED
AFTER ABOVE DATE
WILL APPEAR ON
NEXT STATEMENT
FILL IN AMOUNT
OF PAYMENT
TO INSURE PROPER CREDIT PLEASE DETACH AND RETURN UPPER PORTION WITH PAYMENT.
REORDER FROM WEHOF FORMS 800-221-1209
DATE
QUANTITY
REFERENCE
AMOUNT
All forms f i t UDS and can be
impr inte d to cus tomize
wi th logos, e tc.…
CUSTOM UDS FORMS
Design your own UDS forms to meet and
represent your company’s own needs.
FINANCE CHARGE ON BALANCE OF $
SEE REVERSE SIDE FOR DETAILS.
FINANCE CHARGES ARE LEVIED ON
BALANCES OVER
DAYS OLD.
FINANCE CHARGE SCHEDULE
PAST DUE
BALANCE
TO
$
OVER
$
PERIODIC RATE
PER MONTH
TOTAL BALANCE
ANNUAL
PERCENTAGE RATE
%
%
%
%
STATEMENT
METER TICKET
TO ORDER CALL
800-221-1209
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
49
UNITED DATA SYSTEMS
FORM #UDS1
71⁄4” X 71⁄3” Statement
White 20# Bond
2400/carton
1 ctn. 2,400 $ 26.00/M
2 ctn. 4,800 $ 25.00/M
3 ctn. 7,200 $ 24.00/M
4 ctn. 9,600 $ 23.00/M
5 ctn. 12,000 $ 22.00/M
в—Џ
в—Џ
в—Џ
в—Џ
ACCOUNT NUMBER
BILLED TO:
в—Џ
в—Џ
DATE
REFERENCE
в—Џ
WEHOF FORMS 800-221-1209
#UDS
QUANTITY
в—Џ
в—Џ
в—Џ
FINANCE CHARGE ON BALANCE OF $
SEE REVERSE SIDE FOR DETAILS.
FINANCE CHARGES ARE LEVIED ON
BALANCES OVER
DAYS OLD.
FINANCE CHARGE SCHEDULE
PAST DUE
BALANCE
PERIODIC RATE
PER MONTH
TO
$
OVER
$
в—Џ
вћ§
TOTAL BALANCE вћ§
в—Џ
ANNUAL
PERCENTAGE RATE
%
%
%
%
в—Џ
в—Џ
в—Џ
в—Џ
6
7
8
9
4
3
2
Oil Heat is Best
1
0
AMOUNT
TAX
TOTAL
No.
в—Џ
FROM
IN TANK AFTER
Delivery Date
TRUCK NO.
DRIVER
PAYMENT REC’D.
в—Џ
Check if
Not Full
в—Џ
3
#UDS
5
в—Џ
PRICE
METER READING - END OF DELIVERY
800-221-1209
REORDER FORM #UDS3 FROM WEHOF FORMS
GALLONS
PRODUCT
MAP CODE
PRICE PER GALLON
CUSTOMER
SIGNATURE
PAYMENT
AMOUNT
$
DRIVER’S
SIGNATURE
METER READING - START OF DELIVERY
DATE
TANK SIZE
RECOG. NO.
в—Џ
Late PAYMENT CHARGE is computed on the Previous Balance, after
deducting Payments, at periodic rates of 11 / 2 % per month (an ANNUAL
PERCENTAGE of 18%).
в—Џ
в—Џ
  QTY.
PRICE
в—Џ
AMOUNT
PRICE
PER 1,000
$ 66.00
$ 63.00
$ 60.00
$ 58.00
FORM #BB-1
71⁄4” X 71⁄3” Blue Border
1-ply white 20# bond
2400/carton
1 ctn. 2,400 $ 24.00/M
2 ctn. 4,800 $ 23.00/M
3 ctn. 7,200 $ 22.00/M
4 ctn. 9,600 $ 21.00/M
5 ctn. 12,000 $ 20.00/M
в—Џ
в—Џ
в—Џ
в—Џ
REORDER FROM WEHOF FORMS 800-221-1209
$ 132.00
 $ 252.00
 $ 360.00
 $ 464.00
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
#BB-1
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
*Imprinting available to customize with logos, etc.
www.FormsPro.net
INSERT FACE DOWN - THIS END FIRST
в—Џ
FORM #UDS1
в—Џ
1
в—Џ
TO INSURE PROPER CREDIT PLEASE DETACH AND RETURN UPPER PORTION WITH PAYMENT.
в—Џ
в—Џ
в—Џ
FILL IN AMOUNT
OF PAYMENT
в—Џ
в—Џ
в—Џ
PAYMENTS RECEIVED
AFTER ABOVE DATE
WILL APPEAR ON
NEXT STATEMENT
в—Џ
91⁄2” X 4” 3-ply Meter Ticket
with hard back copy on Ply 3 and
carbonless
2000/carton
  2000
4000
6000
8000
в—Џ
в—Џ
в—Џ
FORM #UDS3*
1 ctn. 
2 ctn. 
3 ctn.
4 ctn.
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
50
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
в—Џ
SIZE
DELIVER
KFA
HWG.
RO
I
N
S
T
R
$
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
S
#ADD
T
M
T
S
REORDER FORM #BUDGET ENELOPE FROM WEHOF FORMS 800-221-1209
в—Џ
вћЅ
M
A
I
L
в—Џ OT
вћЅ
в—Џ
в—Џ
в—Џ
97⁄8” X 7” Laser Statement;
1-Ply; White 20# Bond; 2500/carton
1 ctn. 2,500 $ 26.00/M
2 ctn. 5,000 $ 25.00/M
3 ctn. 7,500 $ 24.00/M
4 ctn. 10,000 $ 23.00/M
в—Џ
в—Џ
в—Џ
TEAR HERE
в—Џ
в—Џ
PLEASE PAY
THIS AMOUNT
PLEASE PAY
THIS AMOUNT
PAYMENT DUE
PAYMENT DUE
ACCOUNT NO.
ACCOUNT NO.
в—Џ
в—Џ
GET
#BUD PE
O
L
ENVE
в—Џ
$ 65.00/M
$ 61.00/M
$ 59.00/M
$ 58.00/M
$ 57.00/M
FORM #ADDS STMT
STATEMENT/INVOICE
в—Џ
в—Џ
1 ctn. 2000
2 ctn. 4,000
3 ctn. 6,000
4 ctn. 8,000
5 ctn. 10,000
в—Џ
в—Џ
в—Џ
F
R
O
M
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
TOTAL $
AMOUNT
TEAR HERE
в—Џ
в—Џ
81⁄2” X 4” 3-ply Meter Ticket with
Non-Freeze Carbons; Hard Back
Copy on Ply 3; 2000/carton
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
PLEASE DETACH AT
VERTICAL PERFORATION
AND RETURN ENTIRELY
WITH YOUR REMITTANCE
в—Џ
в—Џ
в—Џ
CASH
CHECK
$
01234
в—Џ
REORDER FROM WEHOF FORMS 800-221-1209
PRICE
DROP
в—Џ
в—Џ
PAYMENT RECEIVED
TAX
FILL LOC.
$
ZONE
REORDER FORM #ADDS-MT FROM WEHOF FORMS 800-221-1209
D
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L
T
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FORM #ADDS MT*
в—Џ
GALLONS
в—Џ
T
SM
#ADD
T
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в—Џ
PRODUCT DESCRIPTION
PRODUCT
в—Џ
PROD.
DRIVER
в—Џ
B
I
L
L
TANK
DATE
в—Џ
TICKET #
CERTIFIED METER READING
ACCOUNT #
в—Џ
DEL. TIME TRUCK #
IN TANK AFTER
ADD COMPANIES STOCK FORMS
в—Џ
RETAIN THIS
STUB FOR
YOUR RECORDS
в—Џ
в—Џ
в—Џ
в—Џ
AMOUNT PAID $
CHECK NO.
DATE MAILED
DETACH TOP COPY ONLY AT PERFORATION
REORDER FORM ST-2 FROM WEHOF FORMS (800) 221-1209 www.formspro.net
в—Џ
FORM #BUDGET
ENVELOPE 9” X 32⁄3”; 2-ply 20#
Bond, 3000/carton
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    3000 $ 126.00 $ 42.00
2 ctn.  6000  $ 246.00 $ 41.00
3 ctn. 9000  $ 360.00 $ 40.00
4 ctn. 12000  $ 468.00 $ 39.00
FORM #ST-2 SHIFT REPORT TICKET
#ST-2
41/4” X 113/4” 2-Ply NCR stock
w/hard back copy.
2000/ctn
PRICE
  PRICE
PER 1,000
1 ctn.   2000
2 ctn.  4000
3 ctn. 6000
4 ctn. 8000
5 ctn. 10,000
   $ 132.00
  $ 252.00
$ 360.00
$ 456.00
$ 550.00
$ 66.00
$ 63.00
$ 60.00
$ 57.00
$ 55.00
*Imprinting available to
customize with logos, etc.
 
QTY.
TO ORDER CALL
800-221-1209
51
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
CUSTOM ADD FORMS
CUSTOM ADD FORMS
We have
R ave n Ticke ts!
Meter Tickets, Mailers, Statements, & Invoice
Forms, all designed for ADD systems and to
match your corporate image.
l
l
2150 STANLEY TERRACE • UNION, N.J. 07083
(908) 688-1111
l
NJ CONTRACTORS LICENSE # 13VH00052700
l
l
l
l
l
l
l
TEAR HERE
STATEMENT
l
PLEASE DETACH AT
VERTICAL PERFORATION AND
RETURN ENTIRELY WITH YOUR
REMITTANCE
l
l
NJ DIV. OF CONSUMER AFFAIRS 1-888-656-6225
T
EMEN
STAT ER
L
MAI
l
l
l
l
l
l
AR-1
CKET
l
l
INSERT THIS SIDE UP
R TI
METE
l
SEE REVERSE SIDE FOR IMPORTANT INFORMATION
REORDER FROM WEHOF FORMS (800) 221-1209
OFFICE
ADDRESS
DELIVERY
ADDRESS
NT
ENERGY
YOUR
YOUR
BUSINESS
BUSINESS
IS
IS
APPRECIATED.
APPRECIATED.
SERVICE
EME
STAT
OB
DOORKN
KET
IC
T
METER
OPE
L
E
V
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WITH E
FUEL OIL
PROPANE
в—Џ
в—Џ
NJ DIV. OF CONSUMER AFFAIRS • 1-888-656-6225
TICKET #
B
I
L
в—Џ
в—Џ
ZONE
FILL LOCATION
SIZE
DELIVER
TAX
KFA
I
N
S
T
R
HWG.
RO
DROP
DATE
GALLONS
10ths
PRICE
GAL.
AMOUNT
TAX
TOTAL
$
PAYMENT REC'D
CASH
CHECK
DRIVER
BEFORE
AFTER
TRUCK
IN TANK
CUSTOMER'S SIGNATURE
301151
Noneв—Џof the HAZMAT or Fuel Surcharge fees represent a tax or fee paid to or imposed
by any governmental authority and all of the charges are retained by the Company. The
Company has not specifically quantified the relationship between the fees and the actual
costsв—Џ
associated with the fee, which can vary by product, service, time and place, among
other things.
TERMS AND CONDITIONS
X
в—Џ
ALL INVOICES ARE DUE UPON RECEIPT
FINANCE CHARGES ON UNPAID BALANCE WILL START 30 DAYS AFTER DELIVERY
DATE.
в—Џ DELINQUENT ACCOUNTS WILL BE REFERRED TO AN OUTSIDE AGENCY
FOR COLLECTION OR PLACED WITH DISTRICT COURT.
Any collection costs, attorney’s fees and court costs will be added to the total amount due
and is the sole responsibility of the customer.
IN CASE OF ERRORS OR INQUIRES ABOUT YOUR BILL
If you want to preserve your rights under the Fair Billing Credit Act, here is what you
need to do if you think your bill is wrong or if you need more information about an item
on your bill.
THERMAL ROLL TICKETS
(available with
bilingual backers)
PLACE
STAMP
HERE
в—Џ
RARITAN
725-1095
BERGEN
567-1131
KET
METE
L.
T
O
973-372-8022
BRUNSWICK
247-5115
MIDDLESEX
356-2610
462-5999
PRODUCT DESCRIPTION
R TIC
L
T
O
D
E
в—Џ
TANK PROD.
REORDER FROM W E H O F F O R M S 800-221-1209
GRANT OIL •
2150 STANLEY TERRACE • UNION, N.J. 07083
746-3949
(908) 688-1111 • CONTR'S. LIC # 13VH00052700 MARLBORO
ACCOUNT #
10THS
TANK SIZE
GALLON READING - START
PRODUCT
ZONE
GALLON READING - FINISH
ACCOUNT #
SEE BACK FOR IMPORTANT PRODUCT DESCRIPTIONS.
TICKET #
DELIVERY CODE
MONTCLAIR
в—Џ
FUEL
PROPANE HAS AN UNUSUALDIESEL
ODOR,
SIMILAR TO ROTTEN EGGS
DESCRIPTION
OF CHARGE
Propane is heavier than air: therefore, leaks
will
tend to settle
to floor
or basement AMOUNT
levels.
BUDGET
PLANS
To check for propane, carefully smell in low spots. Colds, allergies, sinus congestion
DIRECT DEBIT
and the use of tobacco, alcohol or drugs
may diminish your sense of smell. Cooking or
other strong odors may cover up the smell of gas. On rare occasions, propane gas may
lose its distinctive smell - this is called “ODORANT FADE”. Sometimes propane gas can
lose its odor if a leak occurs underground. Some persons are physically unable to detect
the smell of gas. If you are one of those people call us immediately. For these reasons,
we recommend
that you install a propane gas detector according to the manufacturer’s
в—Џ
instructions.
WHAT TO DO IF YOU SMELL GAS...
1. Put
в—Џ out all smoking materials and other open flames.
2. DO NOT operate a light switch, telephone, cigarette lighter, appliance or
thermostat. Any spark in the area where propane gas is present may ignite the gas.
в—Џ EVERYONE out of the building immediately.PLEASE PAY THIS AMOUNT вћЎ
3. Get
4. Shut off gas supply at the tank or cylinder
(see below).
Terms: Net 30 days from date of delivery. Late charge of 2% (24% Per Annum) or
minimum of phone
$5 per month
be charged
pastthe
due accounts.
5. Call your gas supplier - use your neighbor’s
ifwillgas
odoronisallin
building.
● your propane gas service personREC’D
CHECK and CASH
6. Have
locate and repair the leak, check
вќ’
вќ’
$ before you return.
re-light your gas appliance and air outPAYMENT
the area
FIRST-CLASS MAIL TO:
SERVICE ENERGY, L.L.C.
PO BOX 1000
CHESWOLD DE 19936-1000
INVOICE
KEROSENE
GASOLINE
в—Џ
ACME
Do not write on this bill. On a separate piece of paper write the following
a. Your name and account number.
b. A description of the error and an explanation of why you believe it is an error.
Propane
c. The dollar amount of the suspected error.
PROPANE HAS AN UNUSUAL ODOR, SIMILAR TO ROTTEN EGGS
Propane is heavier than air: therefore, leaks will tend to settle to floor or basement levels.
d. Any other information which you think will help us to identify you or
the forreason
To check
propane, carefully smell in low spots. Colds, allergies, sinus congestion
and the use of tobacco, alcohol or drugs may diminish your sense of smell. Cooking or
for your complaint.
other strong odors may cover up the smell of gas. On rare occasions, propane gas may
lose its distinctive
smell - this
is called “ODORANT FADE”. Sometimes propane gas can
e. Send the billing error notice to: Florida Public Utilities, PO Box 2057,
Salisbury,
MD
lose its odor if a leak occurs underground. Some persons are physically unable to detect
  21802-2057 before 60 days from the date of this invoice.
the smell of gas. If you are one of those people call us immediately. For these reasons,
we recommend that you install a propane gas detector according to the manufacturer’s
METER READING HAS BEEN ADJUSTED TO THE VOLUME instructions.
AT 60ВєF.
WHAT TO DO IF YOU SMELL GAS...
1. Put out all smoking materials and other open flames.
2. DO NOT operate a light switch, telephone, cigarette lighter, appliance or
Any spark in the area where propane gas is present may ignite the gas.
How To Close Gas Supply Valves 3. thermostat.
Get EVERYONE out of the building immediately.
4. Shut off gas supply at the tank or cylinder (see below).
5. Call your gas supplier - use your neighbor’s phone if gas odor is in the building.
Instruciones Para Cerrar La Valvula De Seguridad
6. Have your propane gas service person locate and repair the leak, check and
re-light your gas appliance and air out the area before you return.
Turn shu
Apagar la t of
va
R
LASE NT
E
M
E
T
STA
E
O
V IC
OR IN
e clockwise
alv acia la d to c
ere l
f v ula h
lv
e
os ha
c
Shut off valve here
Apagar la valvula aqui
Shut off
valve here
Apagar la
valvula aqui
None of the HAZMAT or Fuel Surcharge fees represent a tax or fee paid to or imposed
by any governmental authority and all of the charges are retained by the Company. The
Company has not specifically quantified the relationship between the fees and the actual
costs associated with the fee, which can vary by product, service, time and place, among
other things.
TERMS AND CONDITIONS
ALL INVOICES ARE DUE UPON RECEIPT
FINANCE CHARGES ON UNPAID BALANCE WILL START 30 DAYS AFTER DELIVERY
DATE. DELINQUENT ACCOUNTS WILL BE REFERRED TO AN OUTSIDE AGENCY
FOR COLLECTION OR PLACED WITH DISTRICT COURT.
Any collection costs, attorney’s fees and court costs will be added to the total amount due
and is the sole responsibility of the customer.
IN CASE OF ERRORS OR INQUIRES ABOUT YOUR BILL
If you want to preserve your rights under the Fair Billing Credit Act, here is what you
need to do if you think your bill is wrong or if you need more information about an item
on your bill.
Do not write on this bill. On a separate piece of paper write the following
a. Your name and account number.
b. A description of the error and an explanation of why you believe it is an error.
c. The dollar amount of the suspected error.
d. Any PODRIDO.
other information which you think will help us to identify you or the reason
EL PROPANO TIENE UN OLOR PECULIAR, SIMILAR A UN HUEVO
for your complaint.
Send the billing error
notice to: Florida Public Utilities, PO Box 2057, Salisbury, MD
El propano es mГЎs pesado que el aire y por lo tanto las fugas tienden ae.asentarse
sobre
  21802-2057 before 60 days from the date of this invoice.
el piso o niveles del sГіtano. Para comprobar si hay fuga de propano, cuidadosamente
METER READING HAS BEEN ADJUSTED TO THE VOLUME AT 60ВєF.
inhale en niveles bajos. Resfriados, alergias, congestions de la sinus, y el uso de
To Close Gas Supply Valves
tabaco, alcohol o drogas pueden disminuir sus sentidos del olfato. El cocinar How
u otros
Instruciones Para Cerrar La Valvula De Seguridad
olores fuertes pueden disfrazar el olor de gas. En raras ocasiones el gas propano puede
Shut off valve here
Shut off
perder su olor distintivo – a esto se le llama �DESVANECIMIENTO DE ODORANTE’
.
Apagar la valvula aqui
valve here
Apagar la
Aveces el gas propano puede perder su olor si ocurre una fuga subterrГЎneanea. Hay
valvula aqui
personas que fГ­sicamente no pueden detectar el olor de gas. Si es Гєsted una de estas
personas llamenos inmediatamente. Por estas razones recomendamos instale un
detector de gas propano de acuerdo a las instrucciones del fabricante.
QUE HACER SI HUELE GAS…
EL PROPANO TIENE UN OLOR PECULIAR, SIMILAR A UN HUEVO PODRIDO.
1. Apague todo material de fumar y cualquier llama expuesta.
El propano es mГЎs pesado que el aire y por lo tanto las fugas tienden a asentarse sobre
piso
o niveles del sГіtano. Para comprobar si hay fuga de propano, cuidadosamente
2. NO opere ningГєn interruptor de luz, telГЁfono, cigarrillo, enceres, orelinhale
termostato.
en niveles bajos. Resfriados, alergias, congestions de la sinus, y el uso de
alcohol o drogas
pueden disminuir sus sentidos del olfato. El cocinar u otros
Cualquier chispa en el area donde haya propano presente puede tabaco,
encender
el gas.
olores fuertes pueden disfrazar el olor de gas. En raras ocasiones el gas propano puede
3. EvacГєe a todos del edicficio inmediatamente.
perder su olor distintivo – a esto se le llama �DESVANECIMIENTO DE ODORANTE’ .
Aveces el gas propano puede perder su olor si ocurre una fuga subterrГЎneanea. Hay
4. Cierre el suministro de gas en el tanque o cilindro (vea dibujo a seguir)
personas que fГ­sicamente no pueden detectar el olor de gas. Si es Гєsted una de estas
personas
llamenos
Por estas razones recomendamos instale un
5. Llame a su suplidor de gas – use el telèfono de un vecino si hay olor
a gas
eninmediatamente.
su
detector de gas propano de acuerdo a las instrucciones del fabricante.
QUE HACER SI HUELE GAS…
edificio.
1. Apague todo material de fumar y cualquier llama expuesta.
6. Requiera del tГЁcnico de servicio que localize y repare la fuga, revise
vuelva
a
2. NOyopere
ningГєn interruptor
de luz, telГЁfono, cigarrillo, enceres, or termostato.
chispa en el area donde haya propano presente puede encender el gas.
encender su aparato de gas, y ventile el area previo a su regreso 3.alCualquier
edificio.
EvacГєe
a todos del edicficio inmediatamente.
Turn shu
Apagar la t of
va
e
os ha
c
e clockwise
alv acia la d to c
ere l
f v ula h
lv
ER
BACK
4. Cierre el suministro de gas en el tanque o cilindro (vea dibujo a seguir)
5. Llame a su suplidor de gas – use el telèfono de un vecino si hay olor a gas en su
WE ALSO HAVE FORMATS FOR
ADDS SOUTH (EDS) & ADDS
CANADA (STS)
edificio.representan
NingГєn cargos de Materiales Peligrosos (HAZMAT) o Combustile
6. Requiera del tГЁcnico de servicio que localize y repare la fuga, revise y vuelva a
impuestos o cargos pagados o impuestos a autoridades gubernamentales
encenderysutodos
aparato delos
gas, y ventile el area previo a su regreso al edificio.
cargos son retenidos por la compania. La compaГ±Г­a no ha cuantificadoNingГєn
especГ­ficamente
cargos de Materiales Peligrosos (HAZMAT) o Combustile representan
impuestos o cargos pagados o impuestos a autoridades gubernamentales y todos los
la relacion entre los cargos y los costos actuales asociados con los cargos,
los cuales
cargos son retenidos por la compania. La compaГ±Г­a no ha cuantificado especГ­ficamente
la relacion entre los cargos y los costos actuales asociados con los cargos, los cuales
varГ­an por producto, servicio, tiempo y lugar, entre otras cosas.
varГ­an por producto, servicio, tiempo y lugar, entre otras cosas.
TERMINOS Y CONDICIONES
TERMINOS Y CONDICIONES
TODA FACTURA DEBE PAGARSE AL RECIBIRSE
DE FINANZA SE INCIAN 30 DIAS DESPUES DE LA FECHA DE ENTREGA
TODA FACTURA DEBE PAGARSE AL RECIBIRSECARGOS
PARA SALDOS PENDIENTES.
CUENTAS
SERAN REFERIDAS A TERCEROS PARA COLECCION
CARGOS DE FINANZA SE INCIAN 30 DIAS DESPUES DE LA FECHA
DEDELINCUENTES
ENTREGA
O A LA CORTE DEL DISTRITO.
Gastos de colecciГіn, abogados y corte serГЎn aГ±adidos al monto total debido y serГЎ la
PARA SALDOS PENDIENTES.
responsbilidad total del cliente.
CUENTAS DELINCUENTES SERAN REFERIDAS A TERCEROS PARA
COLECCION
EN CASO DE ERRORES O PREGUNTAS SOBRE SU FACTURA
Si
desea
conserver
sus derechos bajo el acto “Fair Billing Credit” a seguir estan las
O A LA CORTE DEL DISTRITO.
instrucciones si cree que su cuenta estГЎ incorrecta o si necesita mas informaciГіn.
Gastos de colecciГіn, abogados y corte serГЎn aГ±adidos al monto total
debido
y
serГЎ
la
No escriba en esta cuenta. En un papel separado escriba lo siguiente:
a. Su nombre y nГєmero de cuenta
responsbilidad total del cliente.
b. Una descripciГіn del error y explicaciГіn del mismo
c. La cantidad monetaria del error
EN CASO DE ERRORES O PREGUNTAS SOBRE SU FACTURA d. Cualquier otra informaciГіn que nos ayude a identificarlo o la razГіn de la queja
EnvГ­e la factura y su carta a: Florida Public Utilities, PO Box 2057 Salisbury, MD
Si desea conserver sus derechos bajo el acto “Fair Billing Credit” a seguir
estan las
21802-2057
Dentro de 60 dias de la fecha de la factura
instrucciones si cree que su cuenta estГЎ incorrecta o si necesita mase.informaciГіn.
LA LECTURA DEL CONTADOR HA SIDO AJUSTADA AL VOLUMEN DE 60F.
No escriba en esta cuenta. En un papel separado escriba lo siguiente:
a. Su nombre y nГєmero de cuenta
b. Una descripciГіn del error y explicaciГіn del mismo
c. La cantidad monetaria del error
d. Cualquier otra informaciГіn que nos ayude a identificarlo o la razГіn de la queja
EnvГ­e la factura y su carta a: Florida Public Utilities, PO Box 2057 Salisbury, MD
21802-2057
www.FormsPro.net
FROM
BILL TO
ADDRESS
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
AUTOMATED WIRELESS/PETRODATA
FORM #AWE-LI1
81⁄2” X 11”; 1-Ply Laser Invoice
White 24# Bond; Printed in Process
Blue Ink; 2500/carton
Date:
Account:
Amount Due:
Amount of Payment: $
TO INSURE PROPER CREDIT PLEASE DETACH UPPER PORTION AND RETURN WITH PAYMENT.
  QTY.
PRICE
I1
Fold
-L
#AWE
Fold
REORDER ORM AWE-AWE-LI WEHOF FORMS 800-221-1209
52
1 ctn.  2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
   $ 65.00
  $ 125.00
$ 180.00
$ 230.00
PRICE
PER 1,000
$ 26.00
$ 25.00
$ 24.00
$ 23.00
FORM #AWE-LS1
-LS1
#AWE
81⁄2” X 11”; 1-Ply Laser Statement
White 24# Bond; Printed in Process
Blue Ink; 2500/carton
  QTY.
PRICE
1 ctn.  2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
   $ 65.00
  $ 125.00
$ 180.00
$ 230.00
PRICE
PER 1,000
$ 26.00
$ 25.00
$ 24.00
$ 23.00
FORM #MLDWE
WE
#MLD
Double Window Envelope for Laser
Invoice/Statements; Blank 24#;
White Wove; 2500/ctn.
  QTY.
PRICE
1 ctn.  2500
2 ctn.  5000
3 ctn. 7500
4 ctn. 10000
TO ORDER CALL
   $ 110.00
  $ 210.00
$ 307.50
$ 400.00
800-221-1209
PRICE
PER 1,000
$ 44.00
$ 42.00
$ 41.00
$ 40.00
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
FORM #TSR4
•
•
•
•
41⁄4” Wide, 345 ft., 1⁄4” core
Blank roll Perfed every 81⁄2” with timing mark
Packaged 8 rolls/ctn.
Premium 20# paper stock to ensure clear lasting
image.
• Rolls are manufactured to exact specs to ensure
trouble free use in the field.
• Competitive prices lower your overhead.
  QTY.
1-6 ctn.
7-13 ctn.
14-20 ctn.
21-24 ctn.
25-38 ctn.
39-50 ctn.
51-63 ctn.
8-48 rolls
56-104 rolls
112-160 rolls
168-192 rolls
200-304 rolls
312-400 rolls
408-504 rolls
53
Blaster Printer
Cognitive Model
LBX42 - 2043
Advantage LX
PRICE
PER ROLL
TSR4
$ 10.40/roll
$ 9.70/roll
$ 9.25/roll 
$ 8.95/roll
$ 8.30/roll Works with Automated
$ 7.20/roll Wireless, K&K Computing,
$ 6.80/roll
TCS & Touchstar software
For higher quant i t ie s, call for a quo te .
AWE CUSTOM FORMS
Meter Tickets, Mailers, Statement and Invoice Forms, all designed for
AWE systems to match your corporate image.
INVOICE
REORDER FROM WEHOF FORMS (800) 221-1209
STATEMENT
STATEMENT
4920 SOUTHERN BLVD, PO BOX 62265
VIRGINIA BEACH, VA 23462-2265
SOUTHSIDE 757-499-5977 • PENINSULA 757-244-4400
WEST POINT 804-843-2121 • RICHMOND 800-899-0747
STATEMENT
www.papco.com
DATE
DATE
ACCOUNT
ACCOUNT
PLEASE INSERT AMOUNT PAID
PLEASE INDICATE AMOUNT PAID
$
PLEASE DETACH AND RETURN THIS
PORTION WITH YOUR PAYMENT
TO INSURE PROPER CREDIT PLEASE DETACH UPPER PORTION AND RETURN WITH PAYMENT
Visit us on-line at www.papco.com
$
REORDER FROM WEHOF FORMS (800) 221-1209
DATE
REFERENCE
DESCRIPTION
AMOUNT
DATE
REFERENCE
AMOUNT
P.O. BOX 465 • FEDERALSBURG, MD 21632
Tel: (410) 754-8184 • (800) 638-7802 • Fax: (410) 754-9158
www.trigas-oil.com
BILL TO
ADDRESS
FREE ON-LINE
PAYMENT
PLEASE
PAY THIS
AMOUNT
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION OR TO NOTE CHANGES.
www.trigas-oil.com
CLICK ON
Pay My Bill
ACCOUNT
STATUS:
DOORKNOB METER TICKET W/BACKER & ENVELOPE
FROM
PLACE
STAMP
HERE
вќ’
вќ’
вќ’
вќ’
вќ’
We appreciate your Business.
DELIVERY
ADDRESS
CASH
CHECK
PAYMENT RECEIVED $_____________________
CHARGE
DRIVER SIGNATURE ________________________
PARTIAL
FILL
DYED FUEL OIL;
NON TAXABLE
USE ONLY;
PENALTY FOR
TAXABLE USE.
Please pay from
this invoice; no
other invoice will
be provided.
вќ’
вќ’
вќ’
CHECK
CASH
CREDIT CARD
CUSTOMER
SIGNATURE:_______________________________________________________
View your account on-line at
PAY THIS AMOUNT
CUSTOMER
SIGNATURE
в–І
www.papco.com
в–І
вњ—
PAYMENTS NOT RECEIVED BEFORE DUE DATE WILL BE ASSESSED
A FINANCE CHARGE OF 1.5% PER MONTH.
01001
PETROLEUM
SEE BACK OF TICKET FOR PRODUCT INFORMATION.
FOR YOUR CONVENIENCE, TRI GAS & OIL ACCEPTS PAYMENT
BY CREDIT CARD. IF YOU WISH TO PAY BY CREDIT CARD,
FILL OUT THE INFORMATION ON THE FLAP ON THE E-Z ENVELOPE.
1632 KINGSTOWN ROAD
PEACE DALE RI 02879-2199
WE ACCEPT:
OFFICE COPY
REV. 8606BA
METER TICKETS
www.FormsPro.net
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
OIL
BLUE COW CUSTOM FORMS
BLUE
W
401 Walcott Street • P.O. Box 1670 • Pawtucket, RI 02862
401-722-0080 • 800-322-5025 • www.dupuisoil.com
COW
software
ehof Forms supplies
high quality, custom printed
business forms for Blue
Cow Software. Give us the
opportunity to give you a quote to meet your forms
requirements and this is what we will do for you;
F Offer you a highly competitive price
F Compose your form on
state of the art graphics
equipment assuring sharp
image quality.
PHONE #
GALS
PREV. BAL.
K FACTOR
Date:
A FINANCE CHARGE OF 18% ANNUAL INTEREST WILL BE
CHARGED ON ALL BALANCES UNPAID AFTER 30 DAYS.
WEHOF FORMS 800-221-1209
TANK SIZE
DATE
IF PAID WITHIN 10 DAYS, PAY:
DD NEXT
AMOUNT
GALS USED
TOTAL
ZONE
K FACTOR
PRICE
CUST. TYPE
CUSTOMER #
Previous Balance
PRICE
GALLONS
DATE
CERTIFIED METER READING
F Produce your form on the
highest quality papers to
assure proper performance.
HEATING OIL / DYED DIESEL FUEL, NON-TAXABLE USE ONLY, PENALTY FOR TAXABLE USE.
JEFF'S OIL
18 Sumner Avenue • Wakefield, MA 01880
Tel (781) 245-3157
JEFF'S OIL
GALS. ORDERED
THIS IS YOUR INVOICE
LASER INVOICE
METER TICKET
We look for ward to the
opport uni t y to pu t our
repu tat ion to work for you!
в—Џ
REORDER FROMWEHOF FORMS 800-221-1209
в—Џ
INVOICE/STATEMENT
в—Џ
9 MOTT AVENUE - SUITE 203
BOX 17
NORWALK, CT 06850
в—Џ
(203) 866-7711
в—Џ
ACCOUNT NO.
BILLING DATE
в—Џ
AMOUNT REMITTED
в—Џ
Abilene Oil Service, Inc.
Fuel Oil — Kerosene — Diesel Fuel
STATEMENT/INVOICE
BILLING DATE
ACCOUNT NO.
1850 Cranston Street • Cranston, RI 02920-4197
DESCRIPTION
CHARGES
PAYMENTS
BALANCE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
CURRENT
в—Џ
B
I
L
L
30 DAYS
60 DAYS
90 DAYS
AMOUNT DUE
в—Џ
в—Џ
ACCOUNT
STATUS >
**1.5% Late charge due on balances outstanding
more than 30 days from date of invoice** (18%
annum)
9 MOTT STREET - SUITE 203
BOX 17
NORWALK, CT 06850
в—Џ
T
O
в—Џ
в—Џ
в—Џ
BILL TO:
в—Џ
в—Џ
DATE
в—Џ
(401) 943-0011
в—Џ
в—Џ
$
в—Џ
в—Џ
в—Џ
в—Џ
THANK YOU
CUSTOMER COPY
в—Џ
AMOUNT
DUE
AMOUNT OF
REMITTANCE
PLEASE RETURN TOP PORTION WITH REMITTANCE
DATE
INVOICE
NUMBER
AMOUNT
DESCRIPTION OF SERVICES
INVOICE
BALANCE
в—Џ
в—Џ
P.O. Box 147 • Windsor, CT 06095
(860) 522-4OIL (4645) • CT LIC.# S-1 388481
“Delivering comfort one house at a time”
FULL PRICE PER GALLON
90 DAYS
DISCOUNT PRICE PER GALLON
AMOUNT DUE
в—Џ
Abilene Oil Service, Inc.
1850 Cranston Street
Cranston, RI 02920-4197
(401) 943-0011
TERMS: ** 1/5% Late charge due on balances
outstanding more than 30 days from date of
invoice** (18% per annum)
Thank You
SENIOR DISCOUNT
PAY DISCOUNT AMOUNT
в—Џ
TRUCK
в—Џ
STATEMENT
DRIVER
TIME
OF DEL.
AM
PM
CASH
CHECK
A FINANCE CHARGE OF 18% ANNUAL INTEREST WILL BE CHARGED ON ALL
CHARGE
BALANCES UNPAID AFTER 30 DAYS.
~ DYED UNMARKED HEATING OIL: NOT FOR USE IN HIGHWAY, NONROAD, LOCOMOTIVE OR MARINE ENGINES.~
PAY THIS AMOUNT
10 DAYS
PAYMENT RECEIVED
CUSTOMER SIGNATURE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
TENTHS
в—Џ
AFTER
в—Џ
WEHOF FORMS 800-221-1209
60 DAYS
DELIVERY DATE
GALLONS
в—Џ
30 DAYS
CURRENT
ORDER DATE
CERTIFIED METER READING
в—Џ
American Reliable Energy, LLC is responsible for the delivery of product to the receiving pipe or
outlet designated by customer. Customer agrees that neither American Reliable Energy, LLC, nor
its employees or agents are or shall be liable under any circumstances for any damages resulting
from leaks or for the failure of the receiving tank or associated piping or any other matter.
54
в—Џ
в—Џ
в—Џ
METER TICKET
TO ORDER CALL
800-221-1209
55
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
BLUE
Call Us
For a
Pr ice
Quo te!
LASER BOND
81⁄2” X 11”
Laser Compatible Bond w/Perf
Available in 20# or 24# Laser Bond
Form #S38 20# w/micro perf -  $ 17.00/M
Form #S39 24# w/micro perf - $ 18.00/M
Also available as 81⁄2” X 14”
in 20# and 24# stock.
FORM #LBC-1 LASER
BUDGET COUPON
DATE
GALLONS
AMOUNT $
DATE
GALLONS
AMOUNT $
PAY M E N T
$
$
TOTAL
TAX
$
CASH
CHECK
AMOUNT
PRICE
$
PAYMENT RECEIVED
$
9
& #S3
FUEL OIL
BUDGET PAYMENT PLAN
RECORD
# DATE CHECK NO. AMOUNT $
1
2
3
4
5
6
7
8
9
10
11
BALANCE
DUE PAYMENT COUPON
12
Below are your BUDGET PAYMENT COUPONS. You will find
a coupon for each of your 11 payments. The PAYMENT AMOUNT
and the month for which it is due will appear in the box of each
coupon. The 12th coupon is to be used for any balance due.
-1
#LBC
ACCOUNT NO.
TOTAL AMT. REC’D �
-1
#LBC
ER
K
C
A
B
TOTAL AMT. PAID пїЅ
BALANCE DUE
PAYMENT DUE
BUDGET PAYMENT COUPON – #11
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #10
BUDGET PAYMENT COUPON – #9
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #8
BUDGET PAYMENT COUPON – #7
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #6
BUDGET PAYMENT COUPON – #5
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #4
BUDGET PAYMENT COUPON – #3
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #2
BUDGET PAYMENT COUPON – #1
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
*Imprinting available to
customize with logos, etc.
www.FormsPro.net
$
$
TAX
TOTAL
01234
#S38
DELIVERY RECORD
$
GALLONS
в—Џ
в—Џ
CASH
CHECK
AMOUNT
$
PRICE
TRUCK #
DEL. TIME
#4-E
PAYMENT RECEIVED
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
$
1
NOW
CARBONLESS!
CERTIFIED METER READING
в—Џ
в—Џ
в—Џ
DRIVER
в—Џ
в—Џ
в—Џ
01234
IN TANK AFTER
в—Џ
в—Џ
GALLONS
DATE
в—Џ
PRODUCT
в—Џ
WEHOF FORMS 800-221-1209 FORM 4-E
в—Џ
WEHOF FORMS 800-221-1209 FORM 3-C
в—Џ
PRODUCT
DRIVER
в—Џ
FORM #4-E*
81⁄2” X 14”; 1-Ply White 24#
Laser Bond with Payment
Record Backer
1000/carton
$ 118.00/M $ 118.00/ctn.
#3-C
в—Џ
DEL. TIME
в—Џ
в—Џ
9 ⁄2” X 4”
Universal Meter Ticket
3-Ply Plus Envelope, NCR
1200/Carton
1-2 ctns.
  $ 130.00/M
3 & Up ctns. $ 125.00/M
TRUCK #
в—Џ
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 132.00 $ 66.00
2 ctn.  4000  $ 252.00 $ 63.00
3 ctn. 6000  $ 360.00 $ 60.00
4 ctn. 8000  $ 464.00 $ 58.00
software
IN TANK AFTER
в—Џ
COW
CERTIFIED METER READING
91⁄2” X 4”
Universal Meter Ticket
3-ply with Non-Freeze Carbons
Hard Back Copy on ply 3
2000/Carton
DATE
FORM #3-C*
BLUE COW STOCK FORMS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
RDS/WinFUELВ®/QUICK OILВ®/TERRA VISTA В®
CUSTOM METER TICKETS
YOUR SALE NO.
в—Џ
220 Route 32
Uncasville, CT 06382
(860) 848-4400
в—Џ
в—Џ
A $30.00 fee will be charged for all returned checks.
в—Џ
ACCOUNT
DELIVERY ADDRESS
PRINTED
вќ’
CI
GAL. DEL.
ZO
D.D.D.D.
BILLING ADDRESS
GALLONS
TIME OF DEL.
в—Џ
DELIVERY DATE
в—Џ
ehof Forms has
been
supplying
high
quality, custom printed
business forms for years.
Our RDS / WinFUELВ®
customer list grows every year
because of our quality, service and
customer satisfaction. Give us the
opportunity to quote on your
forms requirements and this is
what we will do for you:
в—Џ
в—Џ
PREV. BALANCE/CREDIT
PAY THIS AMOUNT
CHECK # ____________ AMOUNT $____________
в—Џ
в—Џ
DRIVER
в—Џ
DATE
в—Џ
AMOUNT
в—Џ
SALES TAX
в—Џ
TICKET
NO.
DEL. DATE
RECEIVED BY
CHECK
CASH
в—Џ
PAYMENT
в—Џ
W
в—Џ
AMOUNT
PRICE
BALANCE
TRUCK
PRICE
в—Џ
JULIAN
DRIVER
FC
в—Џ
BALANCE
SALES TAX
TANK SIZE
FC
NOT FULL
GALLONS
BALANCE
TERMS
TRUCK
PROJ. D.D.
PRINTED
INSTRUCTIONS
CHECK
TERMS
DEGREE DAYS
вќ’
EXCEED 500 PPM SULFUR) DYED;
WARNING: FEDERAL LAW PROHIBITS USE I
N HIGHWAY VEHICLES OR ENGINES, OR IN
NON-ROAD, LOCOMOTIVE, OR MARINE
ENGINES REQUIRING ULSD. ITS USE MAY
DAMAGE THESE DIESEL ENGINES.
LOW SULFUR HIGHWAY DIESEL FUEL (500
PPM SULFUR MAXIMUM) CLEAR;
WARNING: FEDERAL LAW PROHIBITS USE
IN MODEL YEAR 2007 AND LATER
HIGHWAY VEHICLES AND ENGINES. ITS
USE MAY DAMAGE THESE VEHICLES AND
ENGINES.
LOW SULFUR N0N-HIGHWAY DIESEL
FUEL (500 PPM SULFUR MAXIMUM) DYED;
WARNING: FEDERAL LAW PROHIBITS USE
IN HIGHWAY VEHICLES OR ENGINES. NOT
FOR USE IN 2007 AND NEWER
HIGHWAY VEHICLES.
LOW SULFUR KEROSENE (500 PPM
SULFUR MAXIMUM) CLEAR AND UNTAXED;
WARNING: FEDERAL LAW PROHIBITS USE
IN MODEL YEAR 2007 AND NEWER
HIGHWAY VEHICLES AND ENGINES. ITS
USE MAY DAMAGE THESE VEHICLES AND
ENGINES.
LOW SULFUR NON-HIGHWAY KEROSENE
(500 PPM SULFUR MAXIMUM) DYED AND
UNTAXED;
WARNING: FEDERAL LAW PROHIBITS USE
IN HIGHWAY VEHICLES OR ENGINES. NOT
FOR USE IN 2007 AND NEWER
HIGHWAY VEHICLES
CASH
PHONE
DATE LAST DEL.
ZO
CLERK
вќ’
RECEIVED BY
CI
GALLONS
вќ’ HEATING OIL (NO. 2 FUEL OIL) (MAY
вќ’
DYED UNMARKED HEATING OIL: NOT FOR USE IN HIGHWAY, NON-ROAD,
LOCOMOTIVE OR MARINE ENGINES
в—Џ
REORDER FROM WEHOF FORMS • 800-221-1209
в—Џ
SUNSHINE OIL COMPANY
в—Џ
Volume Adjusted to 60Лљ F
GALLON READING FINISH
INSTRUCTIONS
103951
в—Џ
PHONE
DATE LAST
BILLING ADDRESS
GALLON READING START
в—Џ
(570) 929-2843
в—Џ
2 SOUTH KENNEDY DRIVE • McADOO, PA 18237-1806
в—Џ
ACCOUNT
DELIVERY ADDRESS
PREVIOUS SALE NO.
в—Џ
REORDER FROM WEHOF FORMS 800-221-1209
в—Џ
NOTE: THIS IS YOUR BILL. PLEASE PAY FROM THIS INVOICE.
USE ENCLOSED ENVELOPE FOR PAYMENT.
в—Џ
WARGO COAL & OIL DELIVERY, INC.
TERMS: 1.5% MONTHLY FINANCE CHARGE ON PAST DUE ACCOUNTS OVER 30 DAYS, 18% PER YEAR, PROMPT
PAYMENT ENSURES FUTURE DELIVERY. - DYED UNMARKED HEATING OIL: NOT FOR USE IN HIGHWAY, NONROAD, LOCOMOTIVE OR MARINE ENGINES.
TITLE TO THIS MERCHANDISE SHALL REMAIN WITH WARGO COAL & OIL UNTIL BILL IS PAID IN FULL. COMPANY IS
RESPONSIBLE FOR DELIVERY OF PRODUCT TO RECEIVING PIPE OR OUTLET DESIGNATED BY CUSTOMER.
CUSTOMER ACKNOWLEDGES AND AGREES THAT NEITHER THE COMPANY, NOR ITS EMPLOYEES OR AGENTS,
ARE OR SHALL BE LIABLE UNDER ANY CIRCUMSTANCES FOR ANY DAMAGES RESULTING FROM LEAKS OR FOR
THE FAILURE OF THE RECEIVING TANK OR ASSOCIATED PIPING, OR ANY OTHER MATTER.
в—Џ
в—Џ
в—Џ
F Offer you a highly
THIS IS YOUR BILL. PLEASE PAY FROM THIS INVOICE.
в—Џ
ACCOUNT
DELIVERY ADDRESS
в—Џ
в—Џ
в—Џ
DATE LAST
VOLUME CORRECTED TO 60В°F
в—Џ
REORDER FROM WEHOF FORMS • 800-221-1209
в—Џ
PHONE
GALLONS
CL
ZO
LAST D.D.
TERMS
BALANCE
LAST D.D.
JULIAN
BILLING ADDRESS
PRINTED
в—Џ
DATE
FC
в—Џ
CHECK
в—Џ
Mar-Gas LP service, inc.
в—Џ
141CR 406 • SOUTH WESTERLO, NY 12083
в—Џ
(518) 966-8426
NO REFUNDS AND/OR EXCHANGES
state of the art graphics
equipment assuring sharp
image quality.
в—Џ
14751
PRICE
F Compose your forms on
в—Џ
INSTRUCTIONS
CASH
competitive price.
в—Џ
TICKET NO.
в—Џ
F Produce your form on the
в—Џ
highest quality papers to
assure proper performance.
CUSTOM SERVICE
INVOICES
в—Џ
в—Џ
ECONO FUELS, INC.
ECONO
FUELS, INC.
South Racquette Rd. • P.O. Box 546
Massena, New York 13662
Ph.(315) 769-5100 • (800) 786-6105
Fax (315) 764-5342
в—Џ
SOLD TO:
INVOICE
INVOICE DATE
SHIPPED TO:
в—Џ
DELIVERY DATE
в—Џ
GALLONS
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
ACCOUNT NO.
TERMS
DESCRIPTION
в—Џ
INVOICE NO.
в—Џ
в—Џ
в—Џ
We look forward to the opportunity of putting our reputation
to work for you.
REFERENCE
PURCHASE ORDER NO.
UNIT PRICE
WEHOF FORMS 800-221-1209
в—Џ
WEHOF FORMS 800-221-1209
56
JENNINGS
в—Џ
FUEL OIL CO., INC.
&
INVOICE/STATEMENT
JENNINGS
57 Buffalo Street • Elmont, NY 11003
в—Џ
ACCOUNT NO.
в—Џ
в—Џ
в—Џ
в—Џ
AMOUNT REMITTED
в—Џ
в—Џ
DESCRIPTION
CHARGES
PAYMENTS
BALANCE
в—Џ
в—Џ
в—Џ
AMOUNT DUE
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—ЏCURRENT
ACCOUNT
STATUS >
в—Џ
30 DAYS
60 DAYS
90 DAYS
AMOUNT DUE
в—Џ
в—Џ
THANK YOU
JENNINGS & JENNINGS
(718) 827-3679 • (516) 872-3531
TO ORDER CALL
в—Џ
в—Џ
JENNINGS & JENNINGS
в—Џ
в—Џ
в—Џ
PLEASE DETACH AND RETURN WITH YOUR PAYMENT
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
DATE
BILLING DATE
$
в—Џ
AMOUNT
в—Џ
в—Џ
в—Џ
RELEASE NO.
в—Џ
в—Џ
● (718) 827-3679 • (516) 872-3531
в—Џ
в—Џ
в—Џ
800-221-1209
в—Џ
57
OIL MARKETPLACE - SOFTWARE COMPATIBLE FORMS
FUEL DATA SYSTEMS
DLV STA PROD
DD INTVL
ACCOUNT NO.
ACCOUNT NO.
в—Џ
DATE
GALLONS
PRICE/GAL
AMOUNT
в—Џ
TANK SIZE
USEABLE
RUNOUT
TANK SIZE
DLV ST
DATE
GALS
FULL
DD
FILL LOCATION
ACCT ST
DLV ZONE
MMT
PROJ
PZ
#
KFAC
TRUCK
DRIVER
T
O
T
A
L
в—Џ
IN TANK AFTER
PAYMENT REC’D
CASH
CHECK
CUSTOMER SIGNATURE
BILL TO:
$
в—Џ
X
в—Џ
в—Џ
WEHOF FORMS 1(800) 221-1209
в—Џ
TAX
CURR. K
LAST DIGIT DENOTES 1/10th GALLONS
DLV. ZONE
CERTIFIED METER READING
D D NEXT
в—Џ
в—Џ
REORDER FORM # MMT
121⁄2” X 4”
3-Ply NCR Meter Ticket
With Hard Back Copy
2000/Carton
PRODUCT
LAST DIGIT DENOTES 1/10th GALLONS
в—Џ
CERTIFIED METER READING
FORM #MMT*
DD NEXT
LAST FOUR DELIVERIES
PROD.
DELIVERY SCHEDULE
D.D. NEXT
DATE
DEGREE DAY
GALLONS
91⁄2” X 4”
Mid-Com/Neptune Meter
Ticket 3-Ply; only available in
Carbonless Paper;
1500/Carton
1 ctn. 1,500 $ 65.00/M
2 ctn. 3,000 $ 61.00/M
3 ctn. 4,500 $ 59.00/M
4 ctn. 6,000 $ 58.00/M
5 ctn. 7,500 $ 57.00/M
RUN OUT POINT
2
DATED
в—Џ
DATE
DEGREE DAY
в—Џ
в—Џ
в—Џ
в—Џ
D
E
L
I
V
E
R
E
D
T
O
I
N
S
T
R
U
C
T
I
O
N
S
GALLONS
PRICE PER GALLON
R
METE
ET
TICK
ACCOUNT NO.
B
I
L
L
T
O
6
1
0
7
8
в—Џ
CHECK
IF NOT
FULL
9
GALLONS
AMOUNT
TAX
TOTAL
DELIVERY
2 THOMPSON STREET
DATE: P.O. BOX 10
RARITAN,
N.J. 08869
TRUCK NO.
DRIVER
DRIVER NO.
AFFILIATE
(908) 707-1776
(888) 782-3001
FAX (908) 707-4158
PAYMENT
RECEIVED
CUSTOMER
SIGNATURE
P.O. BOX
1071 A
673 NEW BRUNSWICK AVE.
RAHWAY, NJ 07065
(732) 388-1000
BUDGET PAYMENT COUPON – #12
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
в—Џ
в—Џ
в—Џ
find a coupon and envelope for each of your 12 payments.
The PAYMENT AMOUNT and the month for which it is due will
appear in the box of each coupon. To mail a payment,
detach the coupon and mail it in the enclosed envelope.
в—Џ
BUDGET PAYMENT COUPON – #11
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #10
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
в—Џ
FUEL OIL в—Џ
BUDGET PAYMENT PLAN
в—Џ
Below are your BUDGET PAYMENT COUPONS. You will
GET
BUD NS
PO
COU
PAYMENT DUE
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #9
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #8
BUDGET PAYMENT COUPON – #7
ACCOUNT NO.
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE PAY THIS AMOUNT
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #6
BUDGET PAYMENT COUPON – #5
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
в—Џ
DELIVERY DATE
ELAPSED D.D.
PAYMENT DUE
ACCOUNT NO.
PAYMENT DUE
в—Џ
REORDER FROM WEHOF FORMS 800-221-1209
D.D. NEXT
DATED
в—Џ
в—Џ
FILL PIPE LOCATION
LAST FOUR DELIVERIES
DELIVERY SCHEDULE
01234
I
N
S
T
R
U
C
T
I
O
N
S
в—Џ
TANK SIZE
-3
#FDS
T
O
TICKET NO.
в—Џ
MAP CODE
B
I
L
L
T
O
в—Џ
DATE ISSUED
ACCOUNT NO.
D
E
L
I
V
E
R
E
D
в—Џ
в—Џ
5
PRICE PER
GALLON
в—Џ
в—Џ
4
ELAPSED D.D.
3
TANK SIZE
METER READING - START OF DELIVERY
MAP CODE
REORDER FORM FDS-3 FROM WEHOF FORMS 800-221-1209
DATE ISSUED
в—Џ
METER READING - END OF DELIVERY
в—Џ
в—Џ
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #4
BUDGET PAYMENT COUPON – #3
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
в—Џ
в—Џ
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
в—Џ
ACCOUNT NO.
PAYMENT DUE
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
BUDGET PAYMENT COUPON – #2
BUDGET PAYMENT COUPON – #1
PLEASE PAY THIS AMOUNT
PLEASE PAY THIS AMOUNT
ACCOUNT NO.
AFFILIATE
PAYMENT DUE
ACCOUNT NO.
PAYMENT DUE
в—Џ
AVON -860-675-3050 / MANCHESTER - 860-648-1338
23 CHEPACHET RD., AVON, CT 06001-3202
HOD 689 • LIC. 307605
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
в—Џ
LASER BOND
Form #S38
20# w/micro perf - $ 17.00/M
Form #S39
24# w/micro perf - $ 18.00/M
PLEASE DETACH AND MAIL WITH YOUR PAYMENT
SAME
LOW
PRICE
!
81⁄2” X 11”
Laser Compatible Bond w/Perf
Available in 20# or 24# Laser Bond
#S38
9
& #S3
Also available as 81⁄2” X 14”
in 20# and 24# stock.
*Imprinting available to
customize with logos, etc.
www.FormsPro.net
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
01234
PRICE
  QTY.
PRICE
PER 1,000
1 ctn.    2000 $ 160.00 $ 80.00
2 ctn.  4000  $ 312.00 $ 78.00
FORM #FDS-3*
в—Џ
ROLL
T
TICKE
58
OIL MARKETPLACE - USEFUL PRODUCTS
BOILER TAGS
Cus tom boiler tags he lp you maintain an
ongoing mainte nance re cord for your
cus tomers. Wire t ie s are include d.
Do Not Remove This Card
Burner Service Record
DATE
Burner Service Record
Morania Oil of Long
Island
DATE
TECH.
P.O. BOX 111
COLCHESTER, VT 05446
PHONE (516) 679-2000
DATE
TECH.
REMARKS
Burner Service Record
REMARKS
112 COMMERCIAL STREET
FREEPORT, NY 11520
TECH.
phone: 860-4090
email: [email protected]
website: www.ecvt.net
Burner Service Record
REMARKS
DATE
TECH.
REMARKS
REORDER FROM WEHOF FORMS 800-221-1209
REORDER FROM WEHOF FORMS 800-221-1209
ENERGY CO-OP VT-BURNER TAG.indd 1
FURNACE TAGS
Combined
Energy
Services OIL COMPANY, INC.
845-791-HEAT
DATE
REMARKS
6/17/09 3:08:05 PM
Use the se cus tom f ur nace tags to re cord
combus t ion and ef f icie ncy te s t re sul ts
to prov ide a s tandard se r v ice re cord for
your cus tome r.
Combined
Energy
Services OIL
INC.
OIL
COMPANY, INC.
OIL COMPANY,
TECH.
845-791-HEAT
Name
City
Street
Combustion Test
Equipment
Heating Plant
Date
Manuf.
Gross Stk. Temp
Model
CO2 /O2% (Circle One)
вќ’ F. Warm Air
вќ’ F. Hot Water
вќ’ Steam
No. of Zones
Smoke
Manuf.
Net Stk. Temp
Model
Breech Draft
Nozzle (GPH, Angle, Spray)
Overfire Draft
Domestic Hot Water
Efficiency
Rating
Winter K-Factor
вќ’ G. Warm Air
вќ’ G Hot Water
вќ’ Coal Converted
Burner
вќ’ Excellent
вќ’ Good
вќ’ Fair
вќ’ Poor
вќ’ Tankless
вќ’ Gas
вќ’ Electric
вќ’ Oil
вќ’ Tankless with Booster Tank
Temperature Setting
Tankless Size
gpm
Other
Combustion Chamber
вќ’ Replace
вќ’ No Action
вќ’ Repair
Aquastat Setting
Oil Tank Size
WEHOF FORMS 800-221-1209
Work Done By
Gals.
Cert. of Competency No.
Company
WEHOF FORMS 800-221-1209
TO ORDER CALL
800-221-1209
OIL MARKETPLACE - USEFUL PRODUCTS
59
ORDER PADS
WEHOF FORMS 800-221-1209
SERVICE ORDER
Full 100 Sheets Per Pad
of Top Quality 20# Stock
WEHOF FORMS 800-221-1209
RECEIVED BY
ACCT.
NAME
RECEIVED BY
DATE
TIME
ACCT.
NAME
ACCT.
#
CALLED
IN BY
CALLED
IN BY
DATE
TIME
ACCT.
#
CITY
PHONE #
NO CONFUSION WITH THESE
DIFFERENT COLOR FORMS.
PHONE #
ADDRESS
ZIP
COMPLAINT:
DELIVER
TO
NO HEAT
NOT ENOUGH HEAT
NO HOT WATER
NOT ENOUGH H.W.
BILL
TO
RADIATOR VALVE
NOISE
NO COOLING
NOT ENOUGH COOLING
Overall Size 41⁄4” X 71⁄4”
OIL LEAK
WATER LEAK
SMELL
SMOKE
Same Great Price
For Either Form!
OTHER:
GALLONS ORDERED
TANK
SIZE
275
GRADE
550
PRICE
1000
OTHER
INSTRUCTIONS:
CHARGE
PROMISED
DATE
PROMISED
DATE
C.O.D. AMOUNT $
DISPATCHED BY:
1000 Sheets
2000 Sheets
3000 Sheets
5000 Sheets
TIME
TIME
TIME
SCHEDULED DD:
$
$
$
$
23.00/Lot
38.00/Lot
54.00/Lot
84.00/Lot
FUEL DELIVERY REPORTS
Designed to consolidate loading,
delivery, and truck safety information
on one easy to use form. Organized
for better efficiency in daily operations.
CUSTOMER
TICKET
GALLONS GALS. REMAINING
36
37
38
GALLONS
DELIVERED
TOTALS
LOADED AT
TICKET #
$
PRODUCT LOADINGS
GALLONS
}
PRODUCT
FUEL OIL #2
DIESEL FUEL COMBUSTIBLE LIQUID NA 1993 PG III
KEROSENE COMBUSTIBLE LIQUID UN 1223 PG III
GASOLINE 3 (FLAMMABLE LIQUID) UN 1203 PG II
FUEL OIL #2
DIESEL FUEL COMBUSTIBLE LIQUID NA 1993 PG III
}
FORM #FDR-1
KEROSENE COMBUSTIBLE LIQUID UN 1223 PG III
GASOLINE 3 (FLAMMABLE LIQUID) UN 1203 PG II
FUEL OIL #2
DIESEL FUEL COMBUSTIBLE LIQUID NA 1993 PG III
}
KEROSENE COMBUSTIBLE LIQUID UN 1223 PG III
GASOLINE 3 (FLAMMABLE LIQUID) UN 1203 PG II
FUEL OIL #2
1993 PG III
DIESEL FUEL COMBUSTIBLE LIQUID NATICKET
GALLONS
CUSTOMER
WEHOF FORMS 800-221-1209
GALS. REMAINING
ON ACCOUNT
COLLECTED
AMOUNT
}
-1
#FDR 3
RD
& #F
3
OTHER:
TOTAL
LOADED
ON TRUCK
STARTING
4
5
DELIVERY RECONCILIATION
6
METER
FINISH
GALLONS
LOADED
TOTAL TO
ACCOUNT FOR
7
METER
START
8
TOTALIZER
DELIVERED
GALLONS
DELIVERED
TIME
ON TRUCK
FINISH
FINISH
TELEPHONE
EXPENSE
LOST TIME
MILES
9
10
START
11
TOTALS
DRIVER’S PRE-TRIP / POST-TRIP CHECK LIST12
PRE-POST
13
Headlights
Stop Lights & Tail Lights
14
Turn Signals & 4-Way Flashers
Ladder
15
Reflectors
Fuel Tanks & Caps
16
Side Marker Lights
Seat Belts
17
Mirrors
Emergency Equipment
Water Level
18
Proper Vehicle Marking & Placards
Proper Shipping Papers
19
Registration & Insurance Card
Document Pouch
20
Report Any Defects:
Mechanic Repaired
DRIVER
21
DATE
22
23
COMPANY NAME
24
www.FormsPro.net
26
27
в—Џ
25
28
29
30
31
32
33
34
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
в—Џ
35
в—Џ
WEHOF FORMS 800-221-1209
в—Џ
в—Џ
в—Џ
в—Џ
FORM #FDR-3
в—Џ
DATE
DATE
TRUCK NO.
в—Џ
REPORT DATE
в—Џ
Driver Reviewed
-1
#FDR 3
DRF
#
&
ER
BACK
в—Џ
Oil Pressure
Air Pressure
Low Pressure Warning
Reflective Triangles
Horn
Windshield Wipers
Heater - Defroster
Windshield Glass
Dome Cover
Tires & Wheels (Lugs)
Fire Extinguisher
Service Brake
Parking Brake
Apply Brake: Loss Should Not
Exceed 3 PSI Per Minute
Steering
в—Џ
PRE-POST
NO DEFECTS Driver Inspected
One-Part Card Stock with 3-Part
Check List
500 Sheets $ 62.00/Lot
1000 Sheets $ 104.00/Lot
2000 Sheets $ 190.00/Lot
3000 Sheets $ 261.00/Lot
5000 Sheets $ 390.00/Lot
FUEL DELIVERY REPORT
}
KEROSENE COMBUSTIBLE LIQUID UN 1223 PG III
1 PG II
GASOLINE 3 (FLAMMABLE LIQUID) UN 1203
FUEL OIL #2
DIESEL FUEL COMBUSTIBLE LIQUID NA 1993
2 PG III
KEROSENE COMBUSTIBLE LIQUID UN 1223 PG III
GASOLINE 3 (FLAMMABLE LIQUID) UN 1203 PG II
в—Џ
One-Part Card Stock
500 Sheets $ 25.00/Lot
1000 Sheets $ 40.00/Lot
2000 Sheets $ 70.00/Lot
3000 Sheets $ 94.50/Lot
5000 Sheets $ 145.00/Lot
FORM #FDR-3
ON ACCOUNT
COLLECTED
AMOUNT
WEHOF FORMS 800-221-1209
60 OIL MARKETPLACE - USEFUL PRODUCTS
EMERGENCY SPILL RESPONSE KIT
This kit holds all the emergency response items workers depend on! Safety
specialists can’t stress enough the importance of a kit, whether they’re used
for training, first aid, or emergency response. Why? It’s simple - everything a
worker needs is located in one, easy to reach location.
This lightweight emergency response kit is easy to transport and
is packed in a 24” X 24” X 5” resealable poly bag. The spill kit contains
20 oil absorbent pads 17” X 19”, 3 Universal absorbent socks 3” X 48”,
1 tube Drum Repair Epoxy Putty, 1 pair of splash resistant goggles, 1 pair of
Nitrite gloves (chemical resistant), 1 pair vinyl gloves, and 1 extra heavy duty
disposal bag.
1-2 units @ $ 41.00 each
3+ units @   $ 39.00 each
No
t r uck should
be wi thou t one!
TO ORDER CALL
800-221-1209
OIL MARKETPLACE - USEFUL PRODUCTS
SPC OIL SORBENT
Shipped in UPS approved
corrugated boxes!
SPC 100 ­– SUPER MAXIT
DENSITY
15” X 19” X 3/8” - 100/BALE
@ $ 67.00/BALE
(new packaging = lower unit cost)
SPC 200 ­– SUPER ECONOMY
(new packaging = lower unit cost)
15” X 19” X 3/16” - 200/BALE
@ $ 75.00/BALE
SPC 300 –­ MAXIT DENSITY
15” X 19” X 1/4” - 100/BALE
@ $ 56.00/BALE
SPC OIL SORBENTS are the cost effective
way to handle the cleanup and removal of
oil. Proven products in the environmental
sector, the SPC OIL SORBENTS are used
worldwide to assist in the cleanup of many
environmentally sensitive situations.
A heavyweight dimpled material notable
for its low linting, thickness and strength,
these Oil Sorbents do not pick up water.
They are perforated to permit the use of
precisely the right amount of material –
whatever the job.
www.FormsPro.net
61
HVAC
HVAC WORK ORDERS
FORM #CR3 - WORK
ORDER
#CR3
11 ⁄8” x 8 ⁄2” 3-ply NCR form
with hard back copy standard.
Back print with graph sketch area
to layout jobs; red imprint and
sequential numbers; other imprint
colors available for an additional
$15.00 Wash-up Charge;
1000/ctn.
5
1
ER
BACK
PLUMBING WORK ORDER
вќ’ Check that faucet mounting
assembly is secure
вќ’ Check faucet overall condition
вќ’ Check pop-up operation
вќ’ Inspect stops and supply lines
for leaks and corrosion
вќ’ Check tightness of all tubular
drain assemblies
Toilets
вќ’ Inspect around base of bowl
вќ’ Inspect fill valve level and
function
вќ’ Inspect flapper
вќ’ Inspect tank to bowl
component
вќ’ Inspect flush valve
вќ’ Inspect stops and supply line
Tub/Shower
вќ’ Check that faucet mounting
assembly is secure
BATH 2
Reorder from:
visit our website:
www.FormsPro.net
or call 800-221-1209
Lav
QTY
PART NUMBER AND DESCRIPTION
-3
#PLB
TRAVEL TIME
MILEAGE
TIME
ARRIVED ____________________________
ENDING _____________________________________
DATE
STATE
WATER HEATER 1
MAKE
SIZE
ZIP
/
/
DISPATCH #
AGE
вќ’ WARRANTY
вќ’ CONTRACT
вќ’ SERVICE CONTRACT
вќ’ NORMAL
вќ’ RES. вќ’ COMM.
вќ’
WATER HEATER 2
OTHER
PROFESSIONAL DIAGNOSIS
DESCRIPTION
REPAIR NUMBER
/
WORK OR DAYTIME PHONE
CITY
ACCEPT DECLINE
WORK PERFORMED
DESCRIPTION
CUSTOMER
REQUEST:
PRICE
LINE
TOTAL
PRICE
LINE
TOTAL
TOTAL OTHER
CHARGES
SUB-TOTAL
TECHNICIAN
REQUEST:
DIAGNOSTIC CHARGE
PRE-AUTHORIZATION
I HAVE THE AUTHORITY TO ORDER THE ABOVE WORK AND DO SO ORDER AS
OUTLINED ABOVE. IT IS AGREED THAT THE SELLER WILL RETAIN TITLE TO ANY
EQUIPMENT OR MATERIAL FURNISHED UNTIL FINAL AND COMPLETE PAYMENT IS
MADE, AND IF SETTLEMENT IS NOT MADE AS AGREED, THE SELLER SHALL HAVE THE
RIGHT TO REMOVE SAME AND THE SELLER WILL BE HELD HARMLESS FOR ANY
DAMAGES RESULTING FROM THE REMOVAL THEREOF.
TAX
TOTAL
AMOUNT
DUE
X
/
PLUMBING STOCK WO-CR.indd 1
вћ¤
BALANCE DUE UPON COMPLETION.
___________________________________________________________________________
CC or CHECK
AUTHORIZED SIGNATURE
THE ABOVE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY.
ITEM OR PART DESCRIPTION
PRICE
DIAGRAM
HERE
ADDITIONAL PARTS
(BE SURE TO ADD IN ON OTHER SIDE)
Benefits of CAPв„ў (Customer Assurance Pricingв„ў)
We have chosen to utilize Customer Assurance
Pricingв„ў (CAPв„ў) a service provided by a national
company that is the leader in supplying repair tasks to
the industry. The CAPв„ў service provides the fairest and
the most accurate method of service pricing to our
customers. By using this service, you:
•Knowthecostoftherepairbefore the service
technicianstartsthework.
•Havetheopportunitytoacceptordecline
every repair.
•HaveNO billing surprises.
•ExperienceNO open-ended service tickets.
•Areofferedacapped,not to exceed service
price prior to repair.
•Knowthatthetimeyouarepayingforisa
national standard,baseduponwhatthe
entire industry uses to perform similar repairs.
BACKER
ENVIRONMENT
In the case of refrigerant leak repairs, our parts and labor warranty is subject to the following clarifications:
a. You are strongly urged to let the technician show you the location of the leak prior to and after the repair. If this is not possible due to an inconvenient location, be sure
the technician accurately describes the leak location on his service ticket. Our warranty is for the specific leak repaired.
b. Unfortunately, many times there can be more than one leak in a system. We may only locate one and complete an effective repair only to be called out again later and
find another one. Our warranty on the previous leak repair would not cover the new one. However, if within ________ days of the first leak location, we will provide a
no charge diagnostic and leak search. You will then only pay for the repair of the leak, just as you would have done if we had located it on the first trip.
115⁄8” x 81⁄2” 3-ply NCR form with
hard back copy standard. Back print
with Code Compliance statement;
blue imprint and sequential numbers;
other imprint colors available for
an additional $15.00 Wash-up
Charge; 1000/ctn.
/
/
PHONE
STREET
вќ’ Check that faucet mounting
START _______________________________________
assembly is secure
TIME
вќ’ Check faucet overall condition DEPARTED ___________________________ MILES ______________________________________
вќ’ Check pop-up operation
вќ’ Inspect stops and supply lines TRAVEL
X ____________ PER MILE = $____________
TIME ________________________________
for leaks and corrosion
вќ’ Check tightness of all tubular
drain assemblies
Toilets
#
вќ’ Inspect around base of bowl TECHNICIAN
вќ’ Inspect fill valve level and
WARRANTY INFORMATION
function
Work performed includes 1 year parts and labor warranty with the exclusion of
вќ’ Inspect flapper
leak repair, which has a warranty of
at the point of repair.
вќ’ Inspect tank to bowl
component
WATER HEATERS
KITCHEN
вќ’ Inspect flush valve
вќ’ Check shut off valve for
вќ’ Check faucet overall condition
вќ’ Inspect stops and supply line
signs of leak or corrosion
вќ’ Check strainer and disposal
Tub/Shower
вќ’ Check relief valve operation
mounting assembly
вќ’ Check that faucet mounting
вќ’ Check pan and pan line
вќ’ Inspect stops and supply lines
assembly is secure
вќ’ Test thermostatic control
for leaks and corrosion
BATH 3
вќ’ Ohm test of element(s)
вќ’ Check tightness of all tubular
Lav
вќ’ Check electrical connection
drain assemblies
вќ’ Check that faucet mounting
вќ’ Inspect flue vent
вќ’ Check disposer
assembly is secure
вќ’ Inspect thermocouple
вќ’ Check instant hot water
вќ’ Check faucet overall condition вќ’ Inspect burner assembly
вќ’ Check ice maker plumbing
вќ’ Check pop-up operation
вќ’ Inspect pilot feed line
вќ’ Inspect stops and supply lines вќ’ Inspect gas control valve
HOSE BIBS
for leaks and corrosion
вќ’ Check stem packing for leak
вќ’ Check for correct combustible
вќ’ Check tightness of all tubular
вќ’ Check faucet function
air clearance
drain assemblies
вќ’ Check for freeze protection
Toilets
LAUNDRY
вќ’
вќ’ Inspect around base of bowl вќ’ Inspect washer hoses and drain
вќ’ Inspect fill valve level and
вќ’ Test overflow
function
GENERAL
вќ’ Inspect flapper
вќ’ Open and close cut-offs to test
вќ’ City water pressure test
вќ’ Inspect tank to bowl
operation
psi
component
вќ’ Clean aerators as needed
вќ’ Pressure test whole house for
вќ’ Inspect flush valve
leaks
вќ’ Inspect stops and supply line вќ’ Tighten faucet handles
вќ’ Clean fixture after service (bio
вќ’
Tub/Shower
friendly cleaner)
вќ’ Check that faucet mounting
вќ’ Confirm low flow low volume
вќ’
assembly is secure
fixtures
вќ’ Treat septic with bacteria boost вќ’
(if appropriate)
/
DATE ORDERED
DATE SCHEDULED
NAME
EQUIPMENT
SERVICE CHECK LIST
BATH 1
Lav
QUANTITY
FORM #PLB-3
PLUMBING WORK
ORDER
CODE COMPLIANCE
To the best of our knowledge we have made repairs to return your systems to
operable conditions. That repair may or may not meet current plumbing code,
because it is an equal replacement.
FORM #PLB-3
62
AUTH. #
/
7/13/11 10:06 AM
FORM #CR3 & FORM #PLB-3
1000
2000
3000
4000
5000
$ 250.00/M
$ 220.00/M
$ 200.00/M
$ 190.00/M
$ 180.00/M
PORTABLE OFFICE
$ 250.00/lot
$ 440.00/lot
$ 600.00/lot
$ 760.00/lot
$ 900.00/lot
ALUMINUM FORMS HOLDER
• Size 81⁄2” X 12”
’ve
• Holds either vertical or horizontal forms. We
• Designed for right or left hand use.
Got !!
• Provides a solid, smooth writing surface.
ns
a
C
• Bottom storage compartment keeps
paperwork clean and dry (3⁄8” depth).
• Aluminum construction with clear lacquer finish.
Will not absorb liquids, even petroleum products. Buy 1 @ $ 29.00 ea.
2 or more @ $ 26.00 ea.
TO ORDER CALL
800-221-1209
63
PLUMBING  /   P OOL  /   S PA MARKETPLACE
POOL WORK ORDER & POOL/SPA TAG
FORM #PWO-3 - WORK ORDER
1000
2000
3000
4000
5000
$ 250.00/M
$ 220.00/M
$ 200.00/M
$ 190.00/M
$ 180.00/M
$ 250.00/lot
$ 440.00/lot
$ 600.00/lot
$ 760.00/lot
$ 900.00/lot
YOUR COMPANY
NAME, ADDRESS,
AND PHONE NUMBERS
POOL WORK ORDER
CHECK LIST
CHECK ALL PUMP & MOTOR
OPERATIONS
FASTENERS
INOPERABLE
SIZE APPROPRIATE вќ’ YES вќ’ NO
(SEE NOTATION)
SOUND LEVEL
MOTOR RUNNING TEMPERATURE
SHAFT TURNS FREELY
RETURN WATER PRESSURE OK?
PRIMING OK?
EXPLAIN ____________________
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
SIZE CORRECT
SOUND LEVEL
MOTOR TEMP OK?
SHAFT TURNING FREELY
CHECK SPA OPERATIONS
JETS
SPA LIGHT
CHECK SPA VALVES
вќ’
TYPE:
To reorder this form # PWO3 call Wehof Forms – 800-221-1209
вќ’
вќ’
вќ’
visit our website:
www.FormsPro.net
or call 800-221-1209
FILTER
вќ’
вќ’
TYPE:
вќ’
вќ’
VAC SWEEP
вќ’ SWEEP вќ’ SUCTION
вќ’ PRESSURE
вќ’
вќ’
OPERATION
WEAR AND TEAR
вќ’
вќ’
вќ’
вќ’
SKIMMER AND BASKETS CLEAN
BASKETS INTACT
SKIMMER COVERS INTACT
AUTOFILL DEVICE WORKING
PROPERLY
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
GAS вќ’ HEAT PUMP вќ’ ELECTRIC
DOES IT FIRE
CHECK FLAMES
CHECK BURNER TRAY
CHECK FOR GAS LEAK
IS HEATER DIRTY
INOPERABLE
ALL WATER FLOW PROPERLY
OPERATING FOR PROPER HEATER OPERATION
POWER TO UNIT
TOP OF HEATER FREE OF ALL
DEBRIS AND OBJECTS
CHECK FLUE VENTING FOR
RUST AND INTEGRITY
CHECK THERMOSTAT
OPERATION
FIREMAN’S SWITCH OPERATION
CHECK PILOT
CHECK GAS VALVE
CHECK BURNER CLEANLINESS
CHECK BURNER FLAME QUALITY
TEST PRESSURE SWITCH
TUBES, HEAT EXCHANGER
CHECK
EXPLAIN ____________________
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
PART #
DESCRIPTION
NAME
O-3
WATERSIDE
HEATER
CITY
#PW
STATE
MAKE
MODEL
CUSTOMER REPORTS PROBLEM:
1. All parts replaced by us will be warranted to be free for a period of
.
Many service companies provide 30, 60 or 90 day warranties. We feel that the parts we install have
been carefully selected and meet or exceed manufacturer specifications. For this reason we feel
comfortable offering this excellent warranty. The labor to install the warranted part(s) is discussed
in #2 below.
LIGHTINGвЃ„ELECTRICAL
OPERATION
вќ’ SPA BLOWER
вќ’ GFCI
вќ’ FREEZE PROTECTION STA WORKING
вќ’ WIRING CONDUITS INTACT &
CONNECTIONS OK
COVER
вќ’ TYPE: вќ’ AUTOMATIC вќ’ SAFETY
вќ’ WINTER
вќ’ SOLAR
вќ’ REEL OPERATION INCLUDING
вќ’
вќ’
вќ’
PULLEYS AND MECHANISM
ANCHORS AND STRAPS CHECKED
CONDITION OF COVER (TEARS &
RIPS)
CONTROLLER AND MOTOR
OPERATION
CHECK TRACK CLEANLINESS
PHYSICAL
вќ’ PUSH PULL VALVE OPERATION
вќ’ MULTI-PORT VALVE OPERATION
вќ’ ROTOR VALVE OPERATION
❒ O–RINGS
вќ’ LEAKS
вќ’ WATER LEVEL
CHEMICAL SYSTEMS
вќ’ OZONATOR
вќ’ MINERAL PURIFIER (FROG &
вќ’
вќ’
вќ’
вќ’
вќ’
ACCEPT DECLINE
1000
2000
3000
4000
5000
$ 190.00/M
$ 170.00/M
$ 160.00/M
$ 155.00/M
$ 150.00/M
$ 190.00/lot
$ 340.00/lot
$ 480.00/lot
$ 620.00/lot
$ 750.00/lot
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NATURE2 OR OTHER)
вќ’ SIZE OF PURIFIER
вќ’ SALT GENERATOR (TEST SALT
LEVEL)
WORK PERFORMED
DESCRIPTION
REPAIR NUMBER
WORK ORDER FOR APPLIANCES
CHECK LIST
REFRIGERATOR
To reorder this form call Wehof Forms – 800-221-1209
DATE
1068 A Franke Industrial Dr. • Augusta, GA 30909
Office: 706-828-8888 • Fax: 706-738-6850 www.baileysaugusta.com
SC REG M110394 • GA REG CR109820
DATE ORDERED
DATE SCHEDULED
NAME
COOKTOP/RANGE/OVEN
STATE
MAKE & YEAR
TECHNICIAN ________________________________________# __________
ZIP
/
/
DISPATCH #
MAKE & YEAR
YEAR
MODEL
TUB:
/
/
WORK OR DAYTIME PHONE
CITY
DISHWASHER
/
/
PHONE
STREET
вќ‘ GAS вќ‘ ELEC вќ‘ DIGT вќ‘ ANLG
вќ‘ CERAMIC вќ‘ CALROD
вќ‘ S/U SIZES ___________________
вќ‘ OVEN CU. FT._____ WIDTH _____
вќ‘ PLASTIC вќ‘ CERAMIC
вќ‘ S. STL
STYLE: вќ‘ CABINET вќ‘ DRAWER
вќ‘ RINSE AID DISP.
вќ‘ CYCLE # _________
вќ‘ DIGT вќ‘ ANLG
16000
BAILEY’S
APPLIANCE & AIR
PART NUMBER AND DESCRIPTION
QTY
вќ‘ SXS вќ‘ T-MNT вќ‘ B.MNT
вќ‘ ICE MAKER вќ‘ BEV. DISP.
вќ‘ R-134 вќ‘ R-12 вќ‘ OTHER ______
вќ‘ AGE ______ вќ‘ COLOR ______
вќ‘ CONDENSER COIL CHECKED
вќ‘ COIL CONDITION _____________
вќ‘ CMP. FAILURE (M# & S# OF CMP)
SERIAL #
DATE & TIME COMPLETED
YEAR
MODEL
r
r
r
SERIAL #
PROFESSIONAL DIAGNOSIS
DESCRIPTION
/
WARRANTY
CONTRACT
SERVICE
CONTRACT
ACCEPT DECLINE
/
r
r
r
r A.M.
r P.M.
NORMAL
RES. r COMM.
PRICE
LINE
TOTAL
PRICE
LINE
TOTAL
visit our website: www.FormsPro.net
or call 800-221-1209
COLOR ___________
вќ‘ LEAKING WATER
вќ‘ PREVIOUS WATER DAMAGE
вќ‘ WHERE ______ CUST ITL. ______
DISPOSAL
вќ‘ H/P ______ вќ‘ LEAKING WATER
вќ‘ PREVIOUS WATER DAMAGE
вќ‘ WHERE ______ CUST ITL. ______
MICROWAVE
вќ‘ CNTR TOP вќ‘ OVER RANGE
вќ‘ BUILT-IN вќ‘ OVEN COMBO
вќ‘ TRNTBLE вќ‘ RACK/S CU. FT ___
вќ‘ CLR______ вќ‘ WATTAGE ______
WORK PERFORMED
DESCRIPTION
REPAIR NUMBER
visit our website:
www.callahan-roach.com
or call 800-528-0212
WASHER
вќ‘ TOP LOAD вќ‘ FRONT LOAD
вќ‘ DUTY SIZE _____ вќ‘ CYCLES _____
вќ‘ SPACE SAVER (Get dryer specs.)
вќ‘ SPECIAL FEATURE/S __________
вќ‘ DIGT вќ‘ ANLG
вќ‘ LEAKING WATER
вќ‘ PREVIOUS WATER DAMAGE
вќ‘ WHERE ______ CUST ITL. ______
DRYER
SEE REVERSE SIDE FOR ENVIRONMENTAL STATEMENT.
DAMAGE WAIVER
This Damage Waiver relieves Bailey's Appliance of
WARRANTY TERMS
We wish to provide the highest level of professionalism
вќ‘ CHECKED VENT PIPE
interior, exterior or appliance damage resulting and quality service along with the best customer assurance
вќ‘ VENT PIPE CONDITION _________ from acts of nature, customer negligence or policy in the industry. Our service repair warranty policy
REPAIR LOCATION
вќ‘ IN HOME
вќ‘ REMOVED FROM HOME
вќ‘ DROP OFF
OTHER
intentional acts of third parties. This Damage is:
Waiver is limited to specific appliances in
customer's possession and does not extend to 1. All parts replaced by us will be warranted to be free for
items not owned by Bailey's Appliance.
a period of
. Many service
REFRIGERATORS
companies provide 30, 60 or 90 day warranties. We feel
DO NOT RESTOCK with new food 48 hours after that the parts we install have been carefully selected and
a repair. Refrigerator must be operating correctly. meet or exceed manufacturer specifications. For this
reason we feel comfortable offering this excellent warranty.
CUSTOMER’S INITIALS
The labor to install is discussed in #2 below.
вќ‘ PRIOR OBSERVATION OF
2. Our repair labor is warranted for a period of
EQUIPMENT AND SURROUNDINGS
. This is the labor to repair or replace
the part we installed in the initial repair, and not to correct
CUSTOMER INITIALS
DATE
other problems that may have arisen in the interim.
CUSTOMER
REQUEST:
TECH INITIALS
PRE-AUTHORIZATION
I have the authority to order the above work and do so order as outlined above. it is agreed that the
seller will retain title to any equipment or material furnished until final and complete payment is made,
and if settlement is not made as agreed, the seller shall have the right to remove same and the seller
will be held harmless for any for any damages resulting from the removal thereof.
__________________________________________________________________________
AUTHORIZED SIGNATURE
• All part orders will be processed the following business day.
• We will contact the customer when parts are ordered and arrive.
• Ordered parts will not be installed on the same day that they arrive.
• Any item not covered by 3rd party (i.e. warranty, etc.) are the full responsibility of the
homeowner.
__________________________________________________________________________
AUTHORIZED SIGNATURE
WARRANTY AMT.
DIAGNOSTIC CHARGE
TOTAL OTHER
CHARGES
SUB-TOTAL
TOTAL
AMOUNT
DUE
THE ABOVE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY.
X
вћ¤
BALANCE DUE UPON COMPLETION.
CC or CHECK AUTH. #
/
/
APPLIANCE WORK ORDER
www.FormsPro.net
TOTAL
TEST WATER
TEST PH
TEST CHLORINE
TEST PHOSPHATES
POOL WATER BALANCE
FREE CHLORINE 1.0 TO 3.0 PPM
TOTAL CHLORINE 1.5 PPM TO 3PPM CUSTOMER
PH 7.4 TO 7.6 PPM
REQUEST:
TOTAL ALKALINITY 80 T0 150 PPM
TECHNICIAN SIGNATURE:
#
CALCIUM HARDNESS 175 TO
275 PPM
TOTAL BROMINE 3 PPM–5PPM
CHLORINATOR TYPE:
THE ABOVE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY.
вќ’ INLINE вќ’ FLOATING
OVERALL WATER CONDITION
MISC WATER FEATURES
WATERFALL
SCONCE
AUTOFILL
X
/
CC OR CHECK AUTH. #
YOUR COMPANY
NAME, ADDRESS,
AND PHONE NUMBERS
NAME
STREET
-2
#PST
CITY
STATE
ZIP
вќ’ YOUR POOL WAS SERVICED TODAY.
❒ LOCKED OUT – PLEASE CALL TO RESCHEDULE.
вќ’ PLEASE CALL OFFICE.
вќ’ CHEMICALS WERE ADDED TODAY:
вќ’
вќ’
вќ’
вќ’
вќ’
VACUUMED / BRUSHED POOL.
CLEANED / EMPTIED SKIMMER BASKETS.
BACKWASHED / RECHARGED FILTER.
SERVICED SPA.
WE RECOMMEND:
(see reverse side for additional details)
вќ’ REPAIRS COMPLETED:
(see reverse side for additional details)
вќ’ OTHER
visit our website:
www.callahan-roach.com
or call 800-528-0212
CALLAHAN /ROACH
SERVICE TECH.
FORM# PST2
/
BALANCE DUE UPON COMPLETION.
POOL / SPA MAINTENANCE
• From two to multi-plys on NCR stock
• Custom logos and colors to match your Corporate image
• No size limit; we can make it smaller or larger to meet your usage needs
• Infinite versatility in choice layouts
WORK
ORDERS
PRICE
LINE
BASIC SAFETY
DATE
Call for prices.
TOTAL
ANTI VORTEX–SUCTION
FITTINGS
GATE–SELF CLOSING SELF
LATCHING
CONDITION OF DIVING BOARD OR
SLIDE
Thanks for your patronage!
CUSTOM WORK ORDERS
PRICE
LINE
CONTROLS
CHECK AUTOFILL
TIMECLOCKS
ACCURATE TIME
CONDITION OF BOX
TEST CONTROLS–VALVE
OPERATORS
TEST SPA SIDE REMOTE
LIGHTS
GFI
/
/
DISPATCH #
SER. NO.
2. Our repair labor is warranted for a period of
. This is the labor to
repair or replace the part we installed in the initial repair, and not to correct other problems that
may have arisen in the interim.
вќ’ TIME CLOCKвЃ„CONTROLLER TYPE:
вќ’ MECHANICAL вќ’ ELECTRICAL
вќ’ ASSURE PROPER WIRING INTEGRITY
вќ’ LIGHTING OPERATIONS
вќ’ BATTERY BACKUP
вќ’ TIMING SET FOR APPROPRIATE
/
/
/
WORK OR DAYTIME PHONE
ZIP
DESCRIPTION
FORM #PST-2 - POOL/SPA TAG
41⁄4” x 13” 2-ply NCR form with hard back copy
standard. Standard blue imprint and sequential
numbers; other imprint colors available for an
additional $15.00 Wash-up Charge. 1000/ctn.
/
DATE ORDERED
вќ’ WARRANTY
вќ’ CONTRACT
вќ’ SERVICE CONTRACT
вќ’ NORMAL
RES. вќ’ COMM.
вќ’ PUMP вќ’ FILTER вќ’
вќ’
вќ’ CONTROLS
PROFESSIONAL DIAGNOSIS
JOB
LOCATION
WARRANTY TERMS: We wish to provide the highest level of professionalism and quality
service along with the best customer assurance policy in the industry. Our service repair
warranty policy is:
01001
DATE
DATE SCHEDULED
PHONE
STREET
SPAвЃ„BOOSTERвЃ„CLEANER
PUMP
вќ’ SAND вќ’ CARTRIDGE
вќ’DE
PRESSURE READING
BACKWASH VALVE
BLEED VALVE
INOPERABLE
FILTER LARGE ENOUGH FOR
POOL
RECHARGE DE (2ozвЃ„5ft2)
PRESSURE GAUGE OPERATION
AND READABILITY
RELIEF OPERATION CHECKED
вќ’
вќ’
вќ’
вќ’
вќ’
QTY
вњ” NEEDS ATTENTION
PUMPвЃ„MOTOR
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
вќ’
visit our website:
www.callahan-roach.com
or call 800-528-0212
1
В© WEHOF FORMS 4/05
11 ⁄8” x 8 ⁄2” 3-ply NCR form with hard back copy
standard. Back print with graph sketch area to layout jobs;
blue imprint and sequential numbers; other imprint
colors available for an additional $15.00 Wash-up
Charge. 1000/ctn.
5
“Committed to Quality & Service”
To re-order this form call: (800) 221-1209
www.formspro.net
TOTAL OTHER
CHARGES
SUB-TOTAL
DIAGNOSTIC CHARGE
TAX
TOTAL
AMOUNT
DUE
вћ¤
“When it comes to forms…the Pro knows”
PHONE (800) 221-1209
FAX (908) 722-8585
42 READINGTON ROAD
SOMERVILLE, N.J. 08876
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