HAULING DIVISION SALES AGREEMENT

Customer Name *

Date (MM-DD-YYYY) * +

Service Address:

Address *

City *

County *

State *

Zip Code *

Site Contact and Phone *

	Contact Name	Contact Phone Number
Contact Information	Contact Name	Contact Phone Number

Delivery Date (MM-DD-YYYY) * +

Delivery Time *

AM or PM *

AM

PM

Service Address:

Address *

City *

State *

Zip Code *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Type of Material *

Container Size *

Notes

Customer Signature *

clear

Your Signature AUTHORIZES that the total price quoted will be charged to the above requested form of payment before delivery of the container. Any additional fees and expenses will be charged to the same form of payment when incurred. By signing this Sales Agreement the customer hereby agrees to pay for the services rendered by Baltimore Recycling Center, LLC before any services are rendered. Additional fees for tonnage exceeded and container fess will be charged to the same referenced form of payment when incurred. Baltimore Recycling Center LLC is not responsible for any damage when placing the container where requested. All damages are the responsibility of the Customer.

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