Forklift Cylinder Account Agreement Experience the convenience and reliability of Hotgas today! "*" indicates required fields I am (Select one):A new customerAn existing customer, this is a different delivery addressAccount NameContact Person for Account* First Last Primary Contact Ph NumberContact Email* Job Title*Delivery Address* Street Address City Australian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Billing Details*Please complete any additional details if your billing details are different to the key contact details.Same as delivery addressDifferent – please enter belowBilling Address Line 1Billing Address Line 2Suburb*State*QueenslandAustralian Capital TerritoryNorthern TerritoryNew South WalesSouth AustraliaTasmaniaVictoriaWestern AustraliaPostcode*Billing Contact Person/sEmail for invoicing Preferred communication method*PhoneEmailNo preferenceHow many cylinders do you require?*IMPORTANT NOTE: A Facility Fee per cylinder will be charged annually on the anniversary of your account setup. Please visit our Terms and Conditions for full details OR call our office to clarify pricing and fees associated with your account. Delivery InstructionsIs your site clearly numbered* Yes No Where will the cylinder/s be exchanged (location on site)For example: Left hand side, through side gate Or to the R of roller doorAdditional delivery instructionsPlease tick any/all that apply Locked gates/gate code applies We need to be onsite for delivery due to access Challenging driveway Animals at the property Other DetailsWho was your previous supplier?How did you hear about us? Radio Google Facebook Instagram Referral Other For 'Other' or 'Referral'If 'Other' tell us how? If you were referred, please tell us their nameWould you like us to contact you regarding prices?No thanksYes, please call meYes, please email mePlease choose your preferenceDo you need to place an order now?* Yes No IF YES, how many cylinders do you require?Forklift Cylinder Account Terms*By signing this agreement, the account holder (named above) agrees to the following terms & conditions of trade: 1. Facility Fee per cylinder is charged by Hotgas annually for supply of cylinders 2. Cylinders remain the property of Hotgas at all times 3. Cylinders are not to be removed from delivery address on record 4. Additional cylinders must be requested from Hotgas office prior to delivery and will not be supplied by driver on request. This agreement will be altered to reflect additional cylinders supplied 5. Hotgas may undertake a 6 monthly stock take at the delivery address with prior notice. 6. Failure to produce ALL cylinders noted in this agreement will render the customer liable for cost of replacement ($260+GST per cylinder) 7. Customer must notify Hotgas by phone or email regarding account closure – to arrange return of cylinders. Please see our full Terms and Conditions via the link below OR call our office to clarify pricing and fees associated with your account. I agree to Hotgas’ Terms & ConditionsSecurity Field*