Account Terms: Dibble Enterprises, Inc.

Payment Terms:

Payment is due 30 days from the date of the delivery for most accounts. We accept cash, check and credit cards. Credit cards are accepted online at dibbleenterprises.com or you can call the office at (815)-237-2247 during regular business hours, Monday-Friday 7:30a.m.-4:00p.m. - The first delivery is due upon receipt.

Bulk Transport Payment Terms:

Payment is due 10 days from the delivery in the form of check or cash only.

Overdue Accounts:

Overdue accounts will be charged 1.5% per month (18% APR) due after 30 days. To avoid this service charge, we have the following options available to you:

Budget Contract Plans - This plan is based on average usage and/or your account history. Based on this information, an average monthly payment is set up for you at a contracted rate and is due by the end of each month. This program typically runs from August to June for a total of eleven (11) months. In July, your account is reviewed, and you are notified of any credit or balance due.
Payment Arrangements - We understand that circumstances arise and are happy to work with you. Please call the office immediately at (815)-237-2247 if you are unable to pay your bill within 30 days.

Out of gas/short notice fee:

You will be charged $250 if you run out of propane and need service same day, after hours, weekends or holidays. This fee is in addition to the gallons of propane delivered. To avid this fee, we require a 3-5 business day advance notice for all “Will Call” customers Monday - Friday. Please monitor your tank closely to avoid an “Out of Gas/Short Notice Fee”.

*Note*: This fee does not apply to agricultural dryer tanks or “Auto Schedule” customers.

To avoid this fee, and if your tank is 500 gallons or larger, we encourage you to call the office at 815/237-2247 and become an “Auto Schedule” customer. Dibble Enterprises will monitor the tank level for you and place you on a delivery route thus ensuring that you never incur this fee.

MINIMUM DELIVERY: 250 gallons

IMPORTANT PROPANE SAFETY INFORMATION

Gas System Safety Information

*Please not that all fields are required*

Customer Name

First Name

Last Name

Tank Address

(Address #, City, State, ZIP)

Telephone (Cell)

(###)

###

####

Telephone (Alternate):

(###)

###

####

Telephone (Home):

(###)

###

####

Customer Acknowledgement (See Above Safety Brochure)

I understand that a system check and installation review will be completed on my gas system and a safety inspection will be completed. I also understand that if any repairs and/or alterations to my gas system are needed, I will be notified of said repairs/alterations before any work is completed. I further acknowledge, that I have read the Important Safety Information brochure above and acknowledge, by initialing each of the following items that:

I have informed the service technician of all gas burning appliances and gas lines on my property

Please initial

I have smelled the propane gas and can detect its odor

Please initial

I have been told what to do if I smell a gas odor or otherwise suspect a gas leak and have been shown how to turn the gas off at the container

Please initial

I have been told that the odorant giving propane its distinctive smell can fade or diminish in intensity and that certain physical limitations or conditions might prevent me from smelling a gas leak

Please initial

I have been told to consider installing one or more propane gas detectors listed by Underwriters Laboratories

Please initial

I have received safety information and been told to read it and share it with all family members

Please initial

I am satisfied with the service work performed

Please initial

I have read and fully understand this certification

First Name

Last Name

Customer and/or Tenant (E-Signature)

Date

MM

DD

YYYY

Customer Acknowledgement

Please review safety brochure at the bottom of the page

Propane Tank Lease Information

*Please note that all fields are required*

Name

First Name

Last Name

Email

Street Address

(Address #, City, State, Zip)

Billing Address (If different from above)

(Address #, City, State, Zip)

Telephone (Cell):

(###)

###

####

Telephone (Home):

(###)

###

####

Telephone (Alternate):

(###)

###

####

Are you a Renter?

Please choose "Yes" or "No" from the dropdown menu.

If yes, please provide your Landlord's name

(If you do not own this residence, this section must be filled out)

First Name

Last Name

Street Address

(Address #, City, State, Zip)

Landlord's Telephone (Cell):

(###)

###

####

Emergency Contact Info

First Name

Last Name

Telephone (Cell):

(###)

###

####

Which of the following appliances are fueled by propane gas?

Please choose "Yes" or "No" from the dropdown menu.

Furnace?

What Year was the Furnace Installed?

Water Heater?

Dryer?

Stove?

Other appliances?

Lease Agreement

Agreement made and entered into, by and between Dibble Enterprises, Inc., hereinafter referred to as the Company, and (name), hereinafter referred to as the Lessee.

Customer Name

The Company and the Lessee agree to the installation of the following equipment and terms:

The Company Reserves the right to increase and decrease the size as it sees fit. The Company may elect to pick up the tank in the event that no LP gas is purchased within a nine (9) month period. Dibble Enterprises, Inc. is the only company that may put gas in or take gas out of a Dibble Enterprises, Inc. tank.

Contracted Accepted by

(Leasee Name)

First Name

Last Name

E-Sign

Please type your full name into the E-Sign Box.

Date of E-Signature

MM

DD

YYYY