Central Oregon Headquarters
2618 SW 4th Street, Suite B
Redmond, OR 97756
Phone: (541) 504-9444
Fax: (541) 504-1024
E-Mail: CoEnergy@CoEnergy.net
Our Redmond, Oregon Office

 Mid-Willamette Valley Headquarters
2680 SW 3rd Street
Corvallis, OR 97333
Phone: (541) 738-6733
Fax: (541) 738-8306
E-Mail: Info@CoEnergy.net

To better assist you, please fill out our information form below and we will contact you directly.

Name:


Phone: (ex: 541-386-5274)


Address:

Directions to Address:

Tank Information:
Customer Owned
Rented
New

Current Fuel Supplier:

Tank Size (in gallons):

Amount of Fuel in Tank:

Date of Reading: (ex: 11/15/04)

Location of Tank:

Type of Service Requested:
Traditional (Keep Full) Service
Level Pay Service
Metered Service
Commercial Service (reseller, business, etc.)

Appliances:
Heating System (BTU rating: )
Water Heater (BTU rating: , Size in Gallons: )
Cook Stove
BBQ
Free Standing Stove (BTU rating: )
Clothes Dryer
Other

Additional Notes/Comments: