WARDWAY FULES, INC. CREDIT APPLICATION
Full Name:___________________________________Date of Birth:_________________ Social Security Number:__________________Telephone Number:___________________ Present Address:___________________________________________________________ City:____________________________ State:______________ Zip:__________________ How long at present address?___________years Do you own______ or rent________? Previous address if less than 3 years at present address:_____________________________ _________________________________________________________________________ Present Occupation:___________________ How long:_____ Salary_____________monthly Present Employer:_________________________ Employer Phone #:__________________ Other income:__________monthly Source:_______________________________________ Name of nearest relative not living with you:_______________________________________ Number of dependents:____________ ------------------------------------------------------------------------------------------------------------------ Co Applicant Name____________________________Date of Birth:_________________ Social Security Number:__________________Telephone Number:___________________ Present Address:___________________________________________________________ City:____________________________ State:______________ Zip:__________________ How long at present address?___________years Do you own______ or rent________? Previous address if less than 3 years at present address:_____________________________ _________________________________________________________________________ Present Occupation:___________________ How long:_____ Salary_____________monthly Present Employer:_________________________ Employer Phone #:__________________ Other income:__________monthly Source:_______________________________________ Name of nearest relative not living with you:_______________________________________ Number of dependents:____________ ------------------------------------------------------------------------------------------------------------------ Provide the following information about applicant and, if applicable, about the co applicant. Creditor Address Acct # Mnthly Pay Balance ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ The Ohio laws against discrimination require all creditors to make credit available to all credit worthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law. ------------------------------------------------------------------------------------------------------------------ The undersigned hereby fully guarantees the payment of this credit extension and agrees to repayment terms and conditions that WARDWAY FUELS, INC. may set up, and waives any notice of default regarding credit extensions; whether that credit extension be to an individual, group, proprietorship, partnership, corporation, or dba. You are authorized to check my credit and to release information about your credit experience with me. _______________________________________ _____________________________________ Applicant
WARDWAY FULES PRODUCTS SERVICES AND PROGRAMS Products HOME HEATING OIL Nothing heats warmer or more comfortable than oil. We deliver #1 kerosene and #2 low sulphur home heating oil. To prevent your fuel from gelling in extreme cold temperatures, ask for FloMax to be added to your delivery. Tank Shield is another fuel additive which extends oil tank life by controlling sludge and moisture from accumulating in the bottom of your storage tank. PREMIUM ON-ROAD & OFF-ROAD DIESEL FUEL Wardway supplies many Tri-State excavators, contractors, developers, landscapers and other commercial accounts with premium ultra low-sulfur diesel for over the road vehicles, and non-taxable dyed diesel for off-road equipment. Fuel storage tanks and pumps are available. Our On-Road fuel is treated giving you superior mileage and no freeze up in the winter. PROPANE Home, farm, commercial. Wardway should be your choice for propane (LPG). We supply 100 lb. cylinders, bulk tanks ranging in sizes from 100 gallons to 1000 gallons, and underground tanks. We also have 33 lb. cylinders for forklifts. Our service personnel are trained professionals installers. 24-hour emergency service is available for auto-fill customers. GASOLINE We deliver 87 octane and 92 octane gasoline. METHANOL & RACING FUELS Methanol, Methanol w/Edge, and Sunoco Racing gasolines are available by the 55 gallon drum. We sell Sunoco Standard Race Gas (110 octane) by the gallon in our yards. For more information, check out Racegas.com. We also fill nitrous oxide (NOS) tanks. STORAGE TANKS Wardway sells 275, 550, and 1000 gallon fuel oil storage tanks, tank fittings, and nozzles for oil-fired furnaces. We also have 55 gallon drums for sale. Delivery Options AUTOMATIC DELIVERY We use a computerized degree day system to track your heating needs as well as weather patterns. With this information, we schedule your deliveries. The system works so well, you can be confident of never running out of heating oil or propane. Heating your home becomes worry-free! WILL CALL You monitor your usage and call us as needed for deliveries. CASH DISCOUNT Save three ($.03) cents per gallon when paying with cash or money order. Payment Options BUDGET ACCOUNT (Even Billing) Note: This is not an option after November 15th. 1. A calculation is made based on your yearly usage. You pay set monthly payments throughout the year, instead of entire delivery amounts. Payments are due on or before the 1st of each month. A payment booklet is provided for you convenience. 2. Settlement of this account is made in June. Debit balances are due in full by June15th. Any credit balance can be refunded to you at your request or be automatically rolled over into the next year's heating season. 3. Your account will be reviewed periodically and payments adjusted accordingly. 15-DAY CHARGE This is designed for the customer who wishes to pay for deliveries but may not be home at the time of delivery. Our driver will leave a copy of the ticket and payment is due in full fifteen (15) days from the date of delivery. 15 day charge accounts are subject to credit approval. CREDIT CARD This can be handled over the phone at the time the order is placed. We accept VISA, M/C, and DISCOVER. There is a $12.50 convenience fee for credit card orders by phone. There is no fee if order is placed at our office. C.O.D. Pay the driver or pay in advance of delivery with cash, check or money order. TANK DISCLAIMER If you change your tank or tank fill please notify us immediately, so we can update our records. Wardway Fuels, Inc. cannot be held responsible for wrongful fills of unused or out of service tanks that were not brought to our attention. If you have an unused or abandoned tank and need our assistance give us a call. Customer Signature:____________________________________ Date:____________________
VISIT TO RHINELAND, GERMANY - SUNDAY 6 – THURSDAY 10 JULY 2014 - YEAR 8 GERMAN I am arranging a visit from Sunday 6 July to Thursday 10 July 2014 for Year 8 boys studying German to Oberwesel in the Rhineland. The purpose of the visit is to improve students’ German language skills and cultural knowledge. Travel will be by Eagle Line Coaches and Seafrance ferries; a more detailed itinerary
Clinical Pathway and Drug Choices for Chronic Pain in Patients on Dialysis – FHA Renal Program Before selecting drug therapy below, determine current and previously tried analgesics and document on page 2 Neuropathic Pain Component (DN4 score > 4) ►Gabapentin : 200 to 300 mg x 1 HS then 100 mg po QHS and increase weekly to a maximum of 300 mg QHS. ►Acetaminophen to a maximum of