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Capital City Oil

60 years of integrity, reliability, and convenience.

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Credit Application

Thank you for your interest in obtaining a Credit Account at Capital City Oil. For more than 60 years, CCO has been a reliable source for all petroleum needs of a wide range of customers and we are excited to add your name to our portfolio of awesome customers.

Applicant Information

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Name(Required)
Mailing Address(Required)
Email(Required)

Business Information

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Business Type(Required)

Credit Requested

Business Handling

PO Number Required?(Required)
Terms(Required)
10 days/Cash/COD - 5% Lube Discount, .05/Gallon Fuels
Monthly - 2% Lube Discount, .02/Gallon Fuels
This portion of the form authorizes Capital City Oil to be paid with an electronic bank transaction. You will need to upload a voided check below.
I understand that all invoices on my account (including cardlock, tankwagon delivery, lube invoices, etc.) will be paid with an EFT 10 days after the invoice date and tankwagon fuel deliveries and cardlock fuel invoices will be discounted .05 cents per gallon and lubricants will be discounted 5%.
I understand that all invoices posted to my account during the month (including cardlock, tankwagon delivery, lube invoices, etc.) will be paid with an EFT on the 10th of the following month and tankwagon fuel deliveries and cardlock fuel invoices will be discounted .02 cents per gallon and lubricants will be discounted 2%.
I (we) hereby authorize Capital City Oil, Inc., hereinafter called COMPANY, to initiate debit entries to my (our) account indicated below and the financial institution named below, hereinafter called FINANCIAL INSTITUTION, to debit the same to such account.
Address(Required)
Type of Account:(Required)
This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and manner as to afford COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

• All written debit authorizations must provide that the Receiver may revoke the authorization only by notifying the Originator in the manner specified in the authorization.

• Single entry reversals do not require authorization by the Receiver.

Certificates

Sales Tax Exempt?(Required)
(If Yes, tax certificate will be required)
Certificate of Resale?(Required)
(If Yes, tax certificate will be required)
Drop files here or
Max. file size: 256 MB, Max. files: 2.

    Purchasing Information

    Services(Required)

    Ship To (If Different From Company Address)

    Address

    Address

    Purchasing Contact

    Name(Required)

    Billing/AP Contact

    Name

    Account Reference Information

    Contact(Required)
    Address(Required)
    * CREDIT/TRADE REFERENCES MAY BE REQUESTED *
    I HAVE READ AND UNDERSTAND THE CREDIT TERMS as stated on page 2 of this form and do hereby personally guarantee payment of any and all amounts due and owing to Capital City Oil, Inc. for use of the credit account issued via this credit application. All transactions involving the credit extended under this agreement shall be governed by the laws of the State of Kansas, which are expressly adopted to control all transactions hereunder.

    Credit Terms

    CREDIT TERMS

    I submit the following information for consideration by Capital City Oil, Inc. (hereafter referred to as CCO) in order to establish a credit account for the above mentioned Company.

    I hereby authorize the above listed Bank and/or Creditor to release the Company's financial information to CCO, and I authorize CCO to obtain credit reports from business reporting agencies and investigate the Company's credit now and in the future for updates to the account or to extend further credit. This information will be confidential and will only be used for the purpose of establishing credit or collecting amounts due to CCO.P>

    All purchases made on this charge account are due within ten days of each period billing date and failure to do so within thirty days may cause credit to be suspended and will cause a FINANCE CHARGE to be assessed. Any finance charges assessed due to late payment must be paid. The finance charge will be computed by applying to the adjusted balance a periodic rate of 1.5% per month corresponding to the ANNUAL PERCENTAGE RATE OF 18%. A $30.00 fee will be assessed on all returned checks and electronic funds transfers. In the event that it becomes necessary to pursue legal action for the collection of the account, I agree to pay reasonable attorney fees and all other collection charges.

    As the holder of the cardlock card(s) I understand that I may be liable for the unauthorized use of the card(s). I will promptly notify CCO, orally or in writing, if a cardlock card is lost or being used by unauthorized persons. I understand my liability for unauthorized use of such card ends at 11:59 PM on the day of notification to CCO.

    I understand when I give a cardlock card to an employee or friend; I authorized their use and am responsible for all charges to my account.

    I understand the cardlock card(s) issued in my name shall be the property of CCO and may be canceled at any time by CCO, with or without notice. Upon cancellation of the cardlock card(s), I will surrender said card(s) immediately to CCO.

    I understand CCO reserves the right to withdraw this credit privilege at any time for any reason and without notice. Further, CCO reserves the right to require a letter of credit. Such letter is subject to CCO’s approval. I agree to pay the account in full each billing period and recognize the FINANCE CHARGE charged in the event I fail to do so is in recognition of a possible event (my failure to do so), and not an expression of intent to create a revolving or installment charge account.

    CCO may amend this agreement at any time by giving the written notice required by law to the customer whose name appears on the account by mailing a copy of such amendment to the customer’s last known address. All such amendments shall become effective as stated in the written notice and as allowed by law. CCO may at any time in the future amend the applicable FINANCE CHARGE and ANNUAL PERCENTAGE RATE on appropriate notice.
    How did you hear about CCO?
    Salesperson

    Thank you for choosing CCO as your petroleum Supplier.
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    24 Hour Emergency Support: Call 785-233-1300

    If not answered, leave a message and a CCO employee will return your call.

    24 Hour Cardlock Sites Support: CALL 800-877-9013

    You can also view a list of all 24 hour CardLock locations here on our site.

    Click here

    Headquarters

    911 SE Adams St

    Topeka KS 66607

    Phone: 785-233-8008

    Toll Free: 800-211-8008

    Fax: 785-232-3580

    Email: info@capitalcityoil.com

    Hours: 7a-5p M-F

    Kansas City Warehouse

    1128 Swift

    N. Kansas City, MO 64116

    Phone: 816-472-8008

    © Copyright Capital City Oil. All rights reserved.

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