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Fuel Pricing Request Form
Fuels
Attention: Must fill out one form per commodity
Energo Sales Rep Name
*
Energo Sales Rep Email
*
Customer Name
*
Customer's Email
Company Name
*
Region
*
Upstate NY/PA
Downstate NY/NJ
Delivery Address
*
Delivery Address City
*
Delivery Address State
*
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Delivery Address Zip Code
*
Additional Property Addresses (As Needed)
Commodity
*
Select One
#2 Oil
#2 Oil Interruptible
#4 Oil
#4 Oil Interruptible
#6 Oil
Propane
Clear Diesel
Clear Diesel (WB)
Red Diesel
87 Oct (10% Ethanol)
87 Oct (No Ethanol)
89 Oct (10% Ethanol)
89 Oct (No Ethanol)
90 Oct (10% Ethanol)
90 Oct (No Ethanol)
91 Oct (10% Ethanol)
91 Oct (No Ethanol)
93 Oct (10% Ethanol)
93 Oct (No Ethanol)
Kerosene
Tank Size
*
Price Type
*
Select One
Fixed
Index+
Variable
If Fixed
Select One
3 Months
6 Months
12 Months
If Fixed, Term Start Date
If Index
Select One
NYMEX+
Platts+
Argus+
JOC+
Fuel Needed
*
Select One
Fixed Quantity
As Used
Number of Gallons Needed
Current Supplier
*
Proposal Method
*
Add to Nightly Broadcast
Add to Dashboard (OBD)
One Time Quote
Broker Name
Broker Fee Per Gallon
Notes / Feedback / Price to Beat
File Upload (invoice, picture of tank, etc.)
Max. file size: 50 MB.
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