Sign-Up For Service

Customer Name*
First Last
Service Address*
Street Address
Type of Service:
- Residential House
- Residential Apartment
- Commercial Apartment
- Commercial Business
- 3 YD Dumpster Rental
Residential House:
- $70.44/Qtr (1 brown trash can & 1 blue recycling cart)
Residential Apartment:
-$70.44/Qtr (1 brown trash can & 1 blue recycling cart)
-$327.15/Qtr (3 YD dumpster)
Commercial Apartment/Businesses:
-$109.14/Qtr (1 brown trash can & 1 blue recycling cart)
-$452.37/Qtr (3 YD dumpster)
-3 YD Dumpster Rental - One Month
$109.05-Residental
$150.79-Commercial
Additional Services:
-Extra brown can:
(+$33.69/Qtr Residential)
(+$96.39/Qtr Commercial)
-Replacement Can Fee- $50 fee for each cart lost, stolen, or damaged.
-Bulk Item Pickups- 2 free per year. ($50 each additional pickup)
-3 YD Dumpster Rental - One Month
$109.05-Residental
$150.79-Commercial
Price Agreement*
- I agree to the prices above for the services I selected.
Billing Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Number of Tan Trash Bins Needed*
Number of Blue Recycling Bins Needed*
Number of Dumpsters Needed*
Service Start Date*
MM slash DD slash YYYY
Terms and Conditions*
The customer agrees to pay in a quarterly billing cycle. An invoice will be sent for the current quarter once carts are delivered, or once service starts (prorated fees apply). Invoices not paid within 30 days are past due. If payment is not received by the 60th day, services will be discontinued.
- I agree to the above terms and conditions.

For additional information, call 661-832-2635