Dumpster Rental

* Required Fields

Placement Date:	PO#:

Removal Date:	* # of Containers:

* Name / Company Name:
* Ordered By:
* Phone 1:
Phone 2:
* Billing Address:
City:
State:
* Zip:

Directions to site:
Instructions for placement:
Container size available:	13 yd (HxWxL 3.5'x8'x14')
Flat fee for drop off/pick up	$425
Haul dirt, concrete (no rebar), brick	$325

NOTE: Driveways must be protected by owner. We are not responsible for the area that you designate the container to be placed.

EXCLUSIONS: Perishable garbage, tires, barrels, tanks, drums, chemicals, asbestos, toxic or hazardous materials, medical waste, putrescible waste, refrigerants, industrial or process waste.

PAYMENT METHODS:

Credit Card: Card will be charged up front. If applicable, additional costs will be charged when the container has been picked up.
Check: Checks are to be made payable to Harry Braswell, Inc. and should be given to driver at time of delivery. If applicable, additional costs will be invoiced.
Cash: Cash is due upon delivery. If applicable, additional charges will be invoiced.