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APPLICATION FOR COMMERCIAL CREDIT

Date *

Date (m/d/y)

Sales Person *

Phone *

Email *

Business Information

Federal Tax ID *

Year Established *

Legal Company Name *

DBA *

Physical Address (street, city, state, zip) *

Mailing Address (street, city, state, zip) *

Business Phone *

Cell Phone *

Fax *

Email *

Organization *

Year Incorporated *

State of Incorporation *

Type of Business *

Is This Corporation a Subsidiary? *

If Yes, Name of Parent

Parent Corporation State of Incorporation

Accounts Payable Contact Name *

Phone *

Email *

Ownership Information

Owner 1 Name *

Title *

SSN *

DOB *

Home Address (street, city, state, zip) *

Home Phone *

Cell Phone *

Email *

Owner 2 Name

Title

SSN

DOB

Home Address (street, city, state, zip)

Home Phone

Cell Phone

Owner 3 Name

Title

SSN

DOB

Home Address (street, city, state, zip)

Home Phone

Cell Phone

Owner 4 Name

Title

SSN

DOB

Home Address (street, city, state, zip)

Home Phone

Cell Phone

+ Add Another Owner

Bank Reference

Bank Name *

Contact Name *

Phone *

Cardlock Information

Current Fuel Supplier *

Phone *

Fax *

Anticipated Monthly Gallons *

Fleet Manager *

Phone *

Email *

Credit Limit

Credit requested exceeding $20,000.00 please attach current financial statement

Credit Limit Requested *

Current Financial Statement (required for credit over $20,000.00 — PDF, JPG, or PNG)

Current Financial Statement

Upload

Major Trade References

Excluding Credit Cards

Company Name 1 *

Contact Name *

Phone *

Fax *

Company Name 2 *

Contact Name *

Phone *

Fax *

Company Name 3 *

Contact Name *

Phone *

Fax *

Company Name 4

Contact Name

Phone

Fax

I authorize the references listed above to release to Robinson Oil Corporation information related to applicant’s accounts. I warrant the above information to be true and complete. I agree to abide by Robinson Oil Corporation’s Credit Policy, if credit is granted.

Signature of Applicant (type your full legal name) *

Date *

Title of Applicant *

Continue to Commercial Fueling Charge Agreement

COMMERCIAL FUELING CHARGE AGREEMENT

Cardlock Information

This COMMERCIAL FUELING CHARGE AGREEMENT is entered into on

Agreement Date (m/d/y) *

Between Robinson Oil Corporation ("ROC"), and

Customer (Legal Company Name) *

('Customer'), under the following terms and conditions:

Supply of Charge Cards / Payment Obligations

ROC shall supply Customer with Commercial Fueling Charge Cards (“Charge Cards”), for use by Customer’s authorized employees and agents to dispense fuel from designated Cardlock and retail locations.
All obligations incurred through the use of the Charge Cards shall be billed to Customer’s Fueling Charge Account (”Account”), and Customer agrees to pay ROC all amounts charged to the Account. Customer shall not allow the outstanding balance of the Account to exceed the limit which ROC has established for Customer.
ROC will invoice Customer twice each month. Payment in full is due within 15 days. A late charge of 1.5% per month (18% Annual Percentage Rate) will be assessed on any amount not paid within 30 days. Failure of Customer to make timely payments within 30 days entitles ROC to “lock out” all Customer Charge Cards from the system. Reinstatement of the account may result in a $25.00 reset fee.

Security Measures / Loss of Theft of Charge Cards

Each Charge Card will have a Personal Identification Number (“PIN”) which must be entered into the automated keypad system. Customer agrees that input of the correct PIN constitutes authorization to use the Charge Card unless ROC has received actual notice from Customer that such Charge Card has been lost or stolen. Customer shall notify ROC immediately, in writing and by a collect call to (866) 258-5882, of the loss or theft or other unauthorized use of any Charge Card.
Customer agrees that:
1. Use of the Charge Cards by any person who has actual, implied or apparent authority is an authorized user of the Charge Card, whether or not the Customer knows of or approves the specific use.
2. Customer shall be responsible for payment of all charge amounts incurred by (i) any authorized use of any of the Charge Cards, and (ii) any authorized use (including any charges incurred on a lost or stolen Charge Card) prior to actual receipt of notice by ROC of the loss, theft or other unauthorized use of such Charge Card. Customer shall not be responsible for losses incurred or charges made after notice of the loss, theft, or other unauthorized use has been actually received by ROC, and ROC has had sufficient time, after receipt of notice, to “lock out” the lost or stolen card.

General Provisions

ROC may at any time, without cause, or liability to Customer, terminate the Agreement, refuse to extend further credit, and revoke any or all Charge Cards. Customer agrees to surrender such Charge Cards upon ROC’s demand.
No right, interest, or duty of Customer under the Agreement may be assigned or delegated without the prior written consent of ROC. Except as so limited, this Agreement shall be binding on and inure to the benefit of the parties, their successors and assigns.
This Agreement shall be governed by the laws of the State of California. All disputes between ROC and Customer concerning any terms or conditions of this Agreement shall be resolved by a court of competent jurisdiction within Santa Clara County in the State of California.
In the event of any dispute or litigation arising under the Agreement, the prevailing party shall be entitled to recover its reasonable attorney’s fees and costs of litigation.
All notices required or permitted by this Agreement shall be in writing and may be delivered in person (by hand or by messenger or courier service) or may be sent by certified mail, return receipt requested, or by facsimile transmission to ROC, at 955 Martin Ave, Santa Clara, California 95050, FAX (408) 327-4340 or to customer at the address below. All notices shall be deemed given upon receipt. Each party shall promptly notify the other of any change in address.
Commercial fuel may be dispensed from a retail dispenser with a posted retail price. Customer understands and accepts that the commercial price charged to Customer will be different than the posted retail price.
Customer represents and agrees that products purchased through use of a Charge Card will not be used for any purpose that violates the laws of any State in the United States or Canada.
ROC may from time to time, and at its sole discretion, waive or decline to enforce any of its rights under the Agreement (such as forgiving a delinquency, accepting partial payments, or making sales for more than the credit limit) without affecting any other right or remedy of ROC.

Important Notice

Signing this Agreement and/or Using an ROC Commercial Fueling/Cardlock Charge Cards constitutes your acceptance of the conditions in this Commercial Fueling Charge Agreement as of the date first set forth above.

Customer 1 Authorized Signature (type your full legal name)

Customer 1 Authorized Signature (type your full legal name) *

Print Name *

Title *

Date *

Customer 2 Authorized Signature (type your full legal name)

Print Name

Title

Date

Guaranty

The undersigned (“Guarantor(s)”) unconditionally and absolutely, jointly and severally guarantee payment, when due, of any and all amounts owed by Customer to ROC under this agreement.

Guarantor's Signature (type your full legal name)

Guarantor's Signature (type your full legal name) *

Print Name *

Title *

Date *

Home Address (street, city, state, zip) *

ACH Debit – ROC’s Payment Method

I hereby authorize ROC to initiate ACH debits from my account listed below for the payment of ROC invoices.

Please attach a voided check for verification

Bank Name *

9-digit Bank ABA Number *

Account Name *

Account Number *

Voided Check (for ACH verification) (PDF, JPG, or PNG)

Voided Check (for ACH verification) *

Upload

For all future invoiced amounts owed to ROC, I understand that ROC will debit my account weekly or semi-monthly dependent upon invoiced terms. All debits will be supported by a ROC invoice detailing transactions and the total owed. This authority is to remain in full force and effect until ROC has received written notification of its termination or updated bank information in such time and in such manner as to afford ROC a reasonable opportunity to act on it.

Authorized Signature for ACH Debit (type your full legal name)

Authorized Signature for ACH Debit (type your full legal name) *

Print Name *

Title *

Date *

Go back to Application for Commercial Credit

Apply for Your Fleet Fueling Card

APPLICATION FOR COMMERCIAL CREDIT

Business Information

Ownership Information

Bank Reference

Cardlock Information

Credit Limit

Major Trade References

COMMERCIAL FUELING CHARGE AGREEMENT

Cardlock Information

Important Notice

Guaranty

ACH Debit – ROC’s Payment Method