NEW SERVICE APPLICATION

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No Contract Required

EST. 1994

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To apply for our services, kindly fill out the form provided below. It's important to note that we don't require any contract from you.

Company Name

First Name

Date of Birth * required

Click YEAR to scroll.

Tax ID

Last Name

Email Address

Phone

Alt Phone

Billing Address

Billing Address Line 2

City

Region/State/Province

Postal / Zip code

I prefer to rceive my bill by: * Required

Mail

Email (Paperless Billing)

Service Address

Service Address Line 2

City

Region/State/Province

Postal / Zip code

Service Start Date * required

Note

Have you used our services before?

Service Type:

Waste Type

*Heavy Materials & Construction Debris: Concrete, cement, dirt, rocks, bricks, asphalt, large pieces of lumber, and stone.

Container Size

*BEAR: Customer acknowledges that an additional fee will be assessed each time Golden Eagle employees are required to reposition a tipped-over dumpster. Customer further agrees to be responsible for the replacement cost of any container damaged as a result of wildlife activity, misuse, or other actions attributable to Customer.

Frequency of service

*Account holders are responsible for all charges, including overfill and special pickup fees.

*Containers are full when contents reach the top edge; extra fees apply if the lid isn’t closed or items are outside.

*Dumpsters and roll-offs must be emptied at least once every 30 days.

*Invoices are issued monthly after service; payment is due monthly. Late or overdue accounts may incur fees or collection actions. Report invoice errors to Golden Eagle Trash within 30 days.

*The agreement renews monthly and may be ended by either party with 30 days’ written notice.

*Containers must be positioned for collection by 7:00 a.m., regardless of usual service time.

*If service is missed due to weather or other circumstances beyond the provider’s control, pickup will occur on the next available service day. Credits will not be offered for delays caused by weather.

*Golden Eagle Trash disclaims liability for damages to private roads, driveways, or property incurred through normal operations except in cases of provider negligence.

Customer acknowledges that an additional fee will be assessed each time Golden Eagle employees are required to reposition a tipped-over dumpster. Customer further agrees to be responsible for the replacement cost of any container damaged as a result of wildlife activity, misuse, or other actions attributable to Customer.

Your Signature

Todays Date * required

Thanks for submitting!

Golden Eagle Trash Service

goldeneagletrash@pcrs.net

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