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Secure Credit Application

In this Application, “Applicant” means the business entity applying for credit with Cosby Oil Company Inc..
All Starred Fields Are Mandatory.

Company Information

*Legal Business Name

Duns # (Recommended) What is My Duns #?

*Street Address



*Zip Code



*Business Type

*Years In Business

*Federal Tax ID #

Profile Information

*Estimated Monthly Gallon Usage

*Monthly Credit Line Desired $

*Number Of Diesel Vehicles

*Number Of Gas Vehicles

Credit Terms And Conditions

By completing this Application, Applicant acknowledges having read in full our Credit Terms and Conditions, accepts and agrees to the Credit Terms and Conditions, and agrees to comply with the Credit Terms and Conditions set forth herein.

*I have read and accept the Credit Terms and Conditions

By typing your name in the indicated fields, you are agreeing to conduct business by electronic means with Cosby Oil Company Inc., a California corporation (“Cosby”), in accordance with the federal Electronic Signatures in Global and National Commerce Act (E-Sign), 15 U.S.C. Section 7001, et seq., and California's Uniform Electronic Transactions Act, California Civil Code Section 1633, et seq. I understand that under those Acts transactions and/or signatures in records may not be denied legal effect solely because they are conducted, executed, or prepared in electronic form and that if a law requires a record or signature to be in writing, an electronic record or signature satisfies that requirement.



****Cosby Oil Company Inc. reserves the right to request additional information in completing its credit review of the Applicant.****

Personal guarantee and EFT are not required but may affect the approval of your application.

EFT Authorization

I will use EFT (recommended)I will pay another way

Bank Name

Address, City, State, Zip

Account No.

Routing No.

We hereby authorize Cosby and its affiliates, successors and assigns to initiate debit entries to my (our) checking account indicated below, and authorize and direct the depository named below (“Depository”) to debit the same to such account (“EFT”). This is a binding agreement that may be executed by electronic signature, facsimile or other electronic means. This EFT agreement shall remain in full force and effect until Cosby has received written notification from me (us) in such time and manner as to afford Cosby and Depository a reasonable opportunity to act on the notification. This agreement allows Cosby Oil Company to charge debits to this account at frequent intervals for varying amounts. Please attach a voided check, if possible.



Continuing Guarantee

For valuable consideration, including the inducement to provide credit to Applicant (hereinafter called “Debtor”), which would otherwise be denied, the undersigned (hereinafter called “Guarantor”) absolutely and unconditionally guarantees and promises to pay Cosby Oil Company, Inc., a California corporation (herinafter called “Company”) its affiliates, successors and assigns, or order, in lawful money of the United States, any and all indebtedness of Debtor to Company in whatever amount may be owing to Company whether such indebtedness now exists, or is incurred hereafter, whether voluntarily or involuntarily and however arising, whether absolute or contingent, liquidated or unliquidated, determined or undetermined, and whether Debtor may be liable individually or jointly with others (the “Indebtedness”).

Guarantor hereby waives all right to assert or plead at any time any statute of limitations relating to the Indebtedness, the obligations of Guarantor hereunder, and any and all surety or other defenses in the nature thereof including, without limitation, the provisions of California Civil Code Section 2845 or any similar related or successor provision of California law.

This is a continuing guaranty relating to any and all Indebtedness, including, without limitation, Indebtedness arising under successive transactions by electronic means, or otherwise. Company may continue this indebtedness from time to time and may renew it after it has been satisfied, without notice to Guarantor. This Guarantee shall not apply to any indebtedness created after receipt by Company of written notice of its revocation as to future transactions, such notice to be sent by Certified Mail, Return Receipt Requested, to Company at: 12902 East Park Street, Santa Fe Springs, California 90670. The termination of this Guarantee shall not have any retroactive effect with respect to obligations of Debtor incurred prior to termination.

Guarantor agrees that it is directly and primarily liable to Company, that the obligations hereunder are independent of the obligations of Debtor, and that a separate action or actions may be brought against Guarantor whether action is brought against Debtor or whether Debtor is joined in any such action or actions. Guarantor agrees to pay reasonable attorneys’ fees and all other costs and expenses which may be incurred by Company in the enforcement of this Guarantee. This Guarantee shall not be abrogated or affected in any manner by any change in the form or status of the Debtor, whether caused by death, by the admission of any new member, partner or shareholder, by the withdrawal of any member, partner or shareholder , or by any change from any cause whatsoever. The liability of Guarantor hereunder shall in no way be affected by the cessation from any cause whatsoever of the liability of the Debtor for the Indebtedness, including, without limitation, the bankruptcy of Debtor.

No delay on the part of Company in exercising any right hereunder or under the Debtor’s credit agreement shall operate as a waiver of such right or any other right of Company. If there is more than one Guarantor, each and every portion of this Guarantee shall be binding on each and every one of the Guarantors who shall be jointly and severally liable hereunder. This Guarantee is governed by and construed in accordance with California law. This Guarantee is the entire agreement between Company and Guarantor with respect to the subject matter hereof, superseding all prior oral or written agreements or understandings with respect thereto and may not be changed in any manner other than an agreement in writing signed by Guarantor and Company.

I AgreeI Do Not Agree



Social Security Number


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info@cnrgfleet.com | (562) 236-1974