P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 TOLL-FREE (800) 282-5678 742 S. Combee Road, Lakeland FL 33801 Operations Fax: 863-667-0935 Phone: 863-665-7557 Sales Fax: 863-666-2851 Monday – Friday 8 AM – 5 PM Main Fax: 863-665-7634 Email Credit@FleetwingOil.com 24 hour emergency service available FACT SHEET Fleetwing Corporation is a multi-branded petroleum jobber. Fleetwing distributes petroleum products to the citrus, phosphate and road construction industries, as well as fleet owners, excavators and retail automotive outlets throughout the state of Florida. PRODUCT LINES Gasolines, diesel fuels, heating fuel, bulk and packaged lubricants, grease and solvents. FLEET 11 tractors, 54 transport trailers, 18 tank wagons (1,400 to 5,000 gallon capacity), 4 vans for package delivery and 2 service trucks. Air 1: Calumet: Conoco Fleet: TANK FARMS 600,000 gallons of storage capacity for lubricants 140,000 gallons of storage capacity for fuels Diesel Exhaust Fluid Orchex citrus spray oils Lubricating oils and greases AW Hyd 68, Dex III/Merc ATF, 5W20, 5W30 and 10W30 John Deere: Torq-Gard and Hy-Gard Kendall: Automotive lubricants Mobil: Lubricating oils and greases Phillips: Aviation oils FUEL LOCK – CONVENIENCE STORE DIVISION Fleetwing Corporation offers their complete line of products directly to the general public at its headquarters in Lakeland, Florida. The company also markets gasoline and diesel fuel through its card activated fueling station located at the Combee Road complex. FACILITIES Fleetwing Corporation’s headquarters, warehouses and petroleum storage facilities are located on a 25-acre tract on Combee Road in Lakeland. The corporate complex encompasses an administration and office building, a dispatch center and sales office, a maintenance shop, and 20,000 square feet of warehouse space. Fleetwing’s East Coast facility distributes bulk and packaged lubricants, gasolines, diesel fuels and chemicals. This location also offers marine fueling and job site deliveries. OIL ANALYSIS Fleetwing Corporation offers several oil analysis programs to assist you with your preventive maintenance program. Critical results are emailed, telephoned or faxed immediately to the customer. EMPLOYEES Fleetwing employs approximately 74 employees. HISTORY Fleetwing Corporation was established in 1956 under the name of C. Wilson Oil Corporation, and purchased in 1958 by Walter and Elizabeth Smith. In 1965 the name was changed to Fleetwing Corporation and the company relocated from Bartow to the current location on Combee Road in Lakeland Florida. The corporation is still family owned and operated. OFFICERS C. Andy Wike, President Cecilia Smith, Executive Director P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 PHONE (863) 665-7557 TOLL-FREE (800) 282-5678 FAX (863) 665-7634 Date:____________________ Salesperson # Name of Business (Billing Address) Company Name: ________________________________________________ Phone # ( Billing Address: _________________________________________________ Fax # ( )__________________________________ )_____________________________________ Shipping Address: _______________________________________________________________________________________________ Form of Business Proprietorship (Check applicable box) Partnership Corporation Other Type of Business: _______________________________________________ Years in Operation: _____________________________ Resident Agent: ________________________________________ Address: ______________________________________________ Owner/President: ___________________________________V/Pres: ____________________________________________________ S.S. # of Owners (if other than Corp.) Pres: __________________________ V/Pres: _____________________________________ Corp. Fed ID#: _________________ Dunn & Bradstreet #: ______________________________ Facility ID#: _________________ Charge Sales Tax Do Not Charge Sales Tax Certificate #: _______________________________________________ If Exempt include copy of current exemption certificate (Reason for exemption):__________________________________________________________________________________________ Payables Person to Contact: ________________________________ Title: ___________________ Phone #: ____________________ Are Purchase Orders required to charge on your account? Yes No Product Volume Required per month: Fuels_______________ Lubricants _________________ Card Lock _____________________ Requested line of credit if approved: $_____________________________________________________________________________ Bank Reference:________________________________________________________________________________________________ Bank Name Address City State Zip ________________________________________________________________________________________________ Account # (s) Bank Contact Bank Reference:________________________________________________________________________________________________ Bank Name Address City State Zip ________________________________________________________________________________________________ Account # (s) Bank Contact Trade References Telephone Fax 1)______________________________________________________( ) ___________________ ( ) ___________________ 2)______________________________________________________( ) ___________________ ( ) ___________________ 3)______________________________________________________( ) ___________________ ( ) ___________________ 4)______________________________________________________( ) ___________________ ( ) ___________________ 5)______________________________________________________( ) ___________________ ( ) ___________________ “IMPORTANT!” WE MUST HAVE AT LEAST 5 CURRENT REFERENCES. DO NOT LEAVE ABOVE BLANK! By Signature hereof, applicant agrees to the following terms: 1) I hereby represent that I am authorized to submit this application on behalf of the customer named above and it is understood that information will be obtained through personal interviews with third parties, such as business associates, financial sources such as Banks, Dunn & Bradstreet Reporting, and Credit Bureau. These inquiries include information as to application's credit capacity and general credit reputation. 2) If credit is approved and applicant defaults, applicant agrees to pay all costs of collection, including reasonable attorney's fees for amounts collected by suit or by attorney, plus all amounts due company for products or services, including all applicable late fees and interest. All suits shall be brought to Polk County, Florida. 3) Applicant agrees to pay a service charge of 2 1/2% for each past due invoice. In addition, interest at the rate of 1 1/2% per month shall be charged on any unpaid late balance. 4) Terms: COD until credit line is established. Then NET 10 DAYS from date of invoice unless otherwise stipulated. Amounts in excess of credit limit are due upon receipt of product. 5) I/We fully understand that it is a crime punishable by fine or imprisonment or both, to knowingly make any false statements concerning any of the above facts as applicable under FL statutes 817.03-817.031. 6) Discrepancies: All invoices and delivery tickets, whether signed or not ,shall be deemed true and accurate unless alleged discrepancies are reported in writing to Fleetwing within five (5) days after the date thereon. 7) Purchases and deliveries are hereby authorized to be made without signatures. 8) The undersigned, individually, hereby guarantees the prompt payment of the obligations of the company to Fleetwing in accordance with the terms hereof, and all sums payable under or by virtue of the credit extended by Fleetwing to the company, including the principle amount of the credit and all interest which may be due and owing with respect to the credit and all expenses, including reasonable attorney's fees, in connection with any collection agency action brought to collect the credit. The undersigned acknowledges that the foregoing guarantee is an individual obligation of the undersigned and not given incident to his or her corporate position. Further, the undersigned acknowledges and agrees that this provision is a material inducement in Fleetwing's decision to render credit to the company. Please indicate if you would like your invoices sent: Via Email: Email Address: ____________________________________ Signature MANDATORY: Signature of Officer of the Company only. Contact: __________________________________________ Phone: ___________________________________________ Type or Print Name Title Via Fax: Fax No: __________________________________________ Date Contact: __________________________________________ P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 PHONE (863) 665-7557 TOLL-FREE (800) 282-5678 FAX (863) 665-7634 SALES TAX ON OFF ROAD DIESEL ____Yes, I want to be charged sales tax on my off road diesel purchases. ____NO, do not charge sales tax on my off road diesel purchases. I will be responsible for paying the tax to Florida Department of Revenue Use tax due on dyed diesel fuel (off road diesel) must be reported on a Sales Tax and Use Tax Return (form DR-15). Refer to Department of Revenue for more information. Signed by:____________________________________Date:_____________ Printed Name:_________________________________ Company Name:_______________________________ P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 PHONE (863) 665-7557 TOLL-FREE (800) 282-5678 FAX (863) 665-7634 EXEMPTION CERTIFICATE CERTAIN POWER FARM EQUIPMENT, REPAIRS, PARTS, OR ACCESSORIES This is to certify that the power farm equipment, repairs, parts, or accessories described below, purchased or repaired on or after ___________ (date) from _____________________________(Selling Dealer's Business Name) is purchased, repaired, leased, licensed, or rented for the following purpose: ( ) Power farm equipment or irrigation equipment for exclusive use in the agricultural production of crops or products, as produced by those agricultural industries included in s. 570.02(1), F.S., or ( ) Power farm equipment or irrigation equipment for exclusive use in fire prevention and suppression work for such crops or products, as produced by those agricultural industries included in s. 570.02(1), F.S., or ( ) Repairs to, or parts and accessories for, qualifying power farm equipment or irrigation equipment for exclusive use in the agricultural production of crops or products, as produced by those agricultural industries included in s. 570.02(1), F.S., or ( ) Repairs to, or parts and accessories for, qualifying power farm equipment or irrigation equipment for exclusive use in fire prevention and suppression work for such crops or products, as produced by those agricultural industries included in s. 570.02(1), F.S. POWER FARM EQUIPMENT: _____________________________________________________________________________________________ _____________________________________________________________________________________________ _______________________________________________________________________________________ I understand that if I use the equipment for any purpose other than the ones stated above, I must pay tax on the purchase or lease price of the taxable item directly to the Department of Revenue. I understand that if I fraudulently issue this certificate to evade the payment of sales tax, I will be liable for payment of the sales tax plus a penalty of 200% of the tax and may be subject to conviction of a third-degree felony. The exemption specified by the purchaser may be verified by calling 800-352-3671. Purchaser's Name: ____________________________________________________________ Purchaser's Address: ____________________________________________________________ Name and Title of Purchaser's Authorized Representative: ____________________________________________________________ By: _________________________________________________________ (Signature of Purchaser or Authorized Representative) Date: _______________________ P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 PHONE (863) 665-7557 TOLL-FREE (800) 282-5678 FAX (863) 665-7634 EASY PAY SIGN UP FORM I,_____________________________ _________________________________________ Name Title Of _____________________________________________________________________ Name of Business Give Fleetwing Corporation permission to EFT account # ______________________ of _____________________________________________ Bank of ________ with transit and routing #__________________________________ as payment for invoices with agreed terms. This will be effective ______________ . Date _______________________________________________ Please attach a copy of voided check. P.O.BOX 22 LAKELAND, FLORIDA 33802-0022 PHONE (863) 665-7557 TOLL-FREE (800) 282-5678 FAX (863) 665-7634 TANK REGISTRATION Please complete the following: Will you be purchasing: Bulk Fuel Yes No Bulk Lubes Yes No If you answered yes to either question above, please list the number of tanks Fleetwing Corporation will be servicing:______________________________ Do any of the tanks on your property have a capacity greater than 550 gallons (aboveground) or 110 gallons (underground)? Yes No Are any of the tanks stationary (not moved within 180 days)? Yes No If you answered YES to both of the last two questions then you are required to register your tanks with the Department of Environmental Protection Agency. Fleetwing is required to have a copy of the placard for these tanks on file. If you have recently registered your tanks and have not received your placard then please forward a copy of your application, followed with a copy of your placard when it arrives. WE CANNOT MAKE A DELIVERY UNTIL WE HAVE THIS INFORMATION! Should you have any questions regarding the registration of storage tanks, please call DEP in Tallahassee @ (850) 488-3935 or visit their website @ www.dep.state.fl.us/dwn/programs/tanks As the person authorized to sign this statement, under penalties of perjury, I certify the information is correct. _________________________________________________________________ Authorized Signature Date _________________________________________________________________ Title _________________________________________________________________ Company Name JOB INFORMATION SHEET Fax completed form to 863-665-7634 or email to Credit@FleetwingOil.com Customer:_______________________________________________________________ Phone:______________________________________ Street Address:__________________________________________________________ Email: ______________________________________ City: ____________________________________________________________________ State: ___________ ZIP: ______________________ Customer: Owner General Contractor Subcontractor Material Supllier PROJECT INFORMATION PRIME CONTRACTOR NAME NAME STREET ADDRESS STREET ADDRESS PHONE PHONE CITY STATE ZIP CITY STATE OWNER/AWARDING PRIME'S BONDING COMPANY NAME NAME STREET ADDRESS STREET ADDRESS PHONE PHONE CITY STATE ZIP CITY LENDER SUBCONTRACTOR NAME NAME STREET ADDRESS STREET ADDRESS PHONE PHONE CITY STATE ZIP CITY ARCHITECT SUB'S BONDING COMPANY NAME NAME STREET ADDRESS STREET ADDRESS PHONE PHONE CITY STATE ZIP CITY Other ZIP STATE ZIP STATE ZIP STATE ZIP Estimated Quantity:_____________________________________________ Estimated Dollar Value: _________________________________ This job will have: One furnishing Several furnishings Do not know Signature:_____________________________________________________________________ Date: _________________________________ Company ____________________________________________________________________________________________________________