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Additional Garbage Cart Request Form

Phone Number

Utility Account Number

Are you requesting an additional garbage cart for yourself or someone else?

Myself

Someone else

Please explain why you need an additional garbage cart:

How many additional garbage carts do you need?

If name on utility account is different from name above, please explain. Include name currently listed on your utility account.

An additional cart(s) will be charged to the utility bill at $3.00 per cart per month. Any additional carts must be used for a minimum of twelve (12) months.

The City will not collect any debris from the automated carts other than food or paper products.
Automated carts must be placed five (5) feet apart from each other and from mailboxes, utility poles, parked cars, flowerbeds, or any obstruction.
It is not the responsibility of Sanitation Personnel to move carts that are improperly placed in order to complete a collection.
Delivery of any additional cart will not be made without the signature of an authorized person(s) responsible for the charges applied to the utility bill.

Upon receipt of request and authorization for an additional cart delivery will be made within five (5) working days.

By signing below, I acknowledge that:

I request the delivery of an additional cart and authorize the fee of $3.00 per month be applied to the utility bill of the address listed above.
I have read and understand the above charges and guidelines. I request the delivery of an additional cart and authorize the fee of $3.00 per month.

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First Name

Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.