Company Name:

Address:


City: State: Zip Code:

Phone:

Fax:

Contact Name:

Email Address:

Do you prefer a phone call or email with your bid?
Phone Call    
Email

Preferred bin and number of bins necessary:
(indicate the number of bins next to the size desired)
30 Gallon Wooden Console
32 Gallon Plastic Bin )
64 Gallon Plastic Bin

Do you want regular scheduled shredding?
Yes
No

How often do you want your bins picked up?
Weekly
Bi-Weekly
Monthly
Other -- please indicate how often you want your bin picked up:

Do you have specific days that you want your bins picked up every month?

(i.e. the 2nd of the month, the 15th of the month)

ONE-TIME PURGE JOBS:
Some businesses purge their records once or twice a year. If this is the type of service you need, give an estimate of how many bins or pounds you think you will generate when you do your purging so we can approximate a price for your job.

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