TOTAL DUE:

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Date: Name:

Home Phone:

Delivery Address:

Other:

Mailing Address (if different): Email Address: Energex Premium Mixed Pellet (60/40% soft/hardwood )

Bag Size 40# bag 20# bag

Pallet Size 50 bags/ 1 ton 105 bags/ 1.05 ton

Price Quantity $232.00 $257.00

Energex Premium Softwood Pellet 40# bag (100% Softwood)

50 bags/ 1 ton

$242.00

Cubex Premium Hardwood Pellet 40# bag (100% Hardwood) 22# bag

50 bags/ 1 ton 90 bags/ 1 ton

$247.00 $260.00

Payment:

PAID

ACCT.

Delivery:

YES

NO

Stove Cleaning:

YES

NO

Total $

Delivery Fee:

TOTAL DUE: Location:

IN GARAGE -or- ON THE GROUND

Description of Delivery Location: * All pellets are to be picked up during the month of June.

Initial________

*Deliveries will start June 3rd, you MUST be ready

Initial________

* The Farmyard Store is not responsible for any issues pertaining to the transportation of wood pellets picked up by the customer. * Deliveries will receive a call ahead of time to let you know which day we will be dropping your pellets. * Pellet delivery locations are at the sole discretion of the driver. Pellets will be placed where the truck can back up to. * Pellets can be placed in garage locations only if the cement floor quality permits. Tons are handled by a manual floor pallet jack. Please have garage area clean ahead of time. * No Pellet PreBuy refunds Customer Signature