Fleet Credit Application

This Agreement shall be governed by the laws of the state in which the services were initially rendered. Fast Change Lube & Oil is hereby authorized to service the fleet account according to terms provided hereinafter. The services shall be provided in consideration of payment.

Business Name:

Contact Person:

Address:

Street Address Address Line 2 City State ZIP Code

Phone

Fax

Email

Is Your Company Taxable?

Yes
No

Upload Tax Exemption Certificate

If tax exempt, please fax a copy of your tax exemption certificate to 606-298-5937 OR upload a valid exemption certificate below.

Do You Require a PO Number?

Yes
No

Number of Fleet Vehicles:

Do You Require Vehicle Numbers?

Yes
No

Special Mileage Interval Requested?

Authorization:

Drivers can authorize additional services such as air filter replacement, wiper blade replacement, etc.
Call for Authorization of Services

Bank Reference

Bank Name:

Bank Address:

Street Address Address Line 2 City State ZIP Code

Bank Phone Number:

Trade Reference 1

Business Reference Name:

Contact Person:

Contact Phone Number:

Address

Street Address Address Line 2 City State ZIP Code

Trade Reference 2

Business Name:

Contact Person:

Contact Phone Number:

Address

Street Address Address Line 2 City State ZIP Code

Trade Reference 3

Business Name:

Contact Person:

Contact Phone Number:

Address

Street Address Address Line 2 City State ZIP Code

LATE CHARGES. All payments received later than the 15th of the month following the date of billing will be assessed with a 10% late charge per month, (10%) annual, or the highest allowed by the governing state. In the event of a dispute arising under this Agreement and resulting in litigation, the prevailing party shall be entitled to reasonable attorney's fees and court costs as permitted by law.

PRICE CHANGES. Fast Change Lube & Oil reserves the right to raise or lower prices, given a thirty (30) day notice.

OBLIGATION OF THE ACCOUNT. This Agreement in no way obligates Account to having their vehicles serviced at an Fast Change Lube & Oil, but rather serves as an authorization by the Account for Fast Change Lube & Oil to service their fleets. Further, Account agrees to make timely payment for services provided by Fast Change Lube & Oil.

INQUIRES. Questions on billing or suggestions on service should be directed to the fleet department: 606-298-4051

TERMINATION BY EITHER PARTY. Account and Fast Change Lube & Oil both reserve the right to cancel this Agreement with thirty (30) days notice in writing to the other party. Regardless of this notice, Account shall be responsible for the payment of any services rendered to said account.

IT IS FURTHER UNDERSTOOD THAT THIS FLEET AGREEMENT IS OFFERED FOR THE SOLE USE TO DISCOUNT FULL SERVICE OIL CHANGES ONLY. ALL RECOMMENDATIONS BY AMERICAN LUBEFAST ARE BASED ON SEVERE SERVICE BY THE VEHICLE MANUFACTURER.

I certify that the information given above is true and correct to the best of my knowledge. I hereby give Fast Change Lube & Oil permission to verify this information and release all persons and Fast Change Lube & Oil with respect to any such information provided by my financial institution and trade references.*

I certify that the information given above is true and correct to the best of my knowledge. I hereby give Fast Change Lube & Oil permission to verify this information and release all persons and Fast Change Lube & Oil with respect to any such information provided by my financial institution and trade references.

I Agree With The Statement Above
I Disagree With The Statement Above

Signature*

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