**Note, rate noted above is subject to change upon notification by the City of Sallisaw** Name of Company/Individual:

Transcription

1 Office Use Only Customer Account #: Current tonnage Rate: $26.25 per ton (tonnage $25.00, OK State Fee $1.25 per ton) **Note, rate noted above is subject to change upon notification by the City of Sallisaw** Date of Application: COMPANY INFORMATION Name of Company/Individual: (Include DBA name if applicable) Private Hauler Individual Corporation LLC Other Address of Business: City State Zip Phone: Fax: Federal Tax ID or Social Security Number: Type of Business: Number of Employees: If applicant is a corporation, please list names and addresses of up to two corporate officers. If applicant is a limited liability company, please list name and contact information of manager. Page 1 of 5

2 How long has company been in business? At current address? Have you done business with the City of Sallisaw under any other name? Yes No If yes, please list name: Has your company conducted business with other landfill facilities? Yes No If yes, please list name of facility and contact information with most recent listed as No. 1: 1. Facility #1: Contact/Phone: 2. Facility #2: Contact/Phone: 3. Facility #3: Contact/Phone: DESCRIPTION OF WASTE Estimated monthly tonnage that you will bring to our facility: Description of waste that you will bring to our facility: Where will this waste originate from? BILLING INFORMATION Name of person responsible for payment of charges: Bill to Company/Individual: Address to send invoices/statements: Company: Address: City State Zip Phone: Fax: Attention: Address: Page 2 of 5

3 BANKING INFORMATION Name of Bank: Address: City State Zip Contact Name: Account Number: CREDIT REFERENCES: 1. Definitions: TERMS AND CONDITIONS a. Solid Waste: The term "solid waste" means any garbage, refuse or rubbish resulting from Residential, Industrial and/or commercial activities, but shall not include any infectious waste, hazardous waste, radioactive, volatile, corrosive, highly flammable, explosive, biomedical, infectious, bio-hazardous, toxic or hazardous material, as defined by applicable federal, state or local laws or regulations ("Excluded Waste"), or any garbage, refuse or rubbish which is required by any governmental authority or by its general nature to be handled or disposed of other than in accordance with the Disposal Facility's normal operating procedures as exist on the date hereof b. Hazardous Waste: The term "hazardous waste" means waste, materials, substances or sludges (a) listed or characterized as "hazardous" in the Resource, Conservation and Recovery Act of 1976, the Comprehensive Environmental Response, Compensation and Liability Act, the Toxic Substances Control Act, the Occupational Health and Safety Act, any comparable state or local law, and all rules and regulations promulgated under any of the foregoing, each as amended, including future amendments thereto, excluding minimal quantities of such material typically found in municipal and household refuse Page 3 of 5

4 which are permissible for disposal at the Disposal Facility under applicable laws or (b) otherwise restricted under all governmental licenses, permits and approvals required for the operation of the Disposal Facility as currently operated. 2. The City of Sallisaw reserves the right to suspend and or terminate services at any time. 3. Use of the solid waste facility shall be during posted business hours. These hours are subject to change. Use of the solid waste facility outside normal operating hours may incur special use fees. 4. Drivers must obey all signs and instructions of attendants while utilizing the solid waste facility. Failure to do so can result in suspension of services and or banishment from the facility. 5. The City of Sallisaw is not responsible for any damage sustained to vehicles or equipment while using the solid waste facility. 6. CHARGES & PAYMENTS a. The disposal rate based on tonnage shall be the actual weight of the material disposed of. This will be calculated using the in and out weights of the transporting vehicle or a previously entered tare weight of the vehicle. b. All items disposed of will be charged any required state or federal fees. c. All charge accounts of the Sallisaw Municipal Solid Waste Facility are due paid in full by the due date shown on the monthly statements. A late fee of 1.5% per month will be accessed for all charges not paid in full by the due date. The City of Sallisaw reserves the right to suspend services for nonpayment. d. Customer agrees to pay all late fees. Failure to pay all charges due can result in suspension and or termination of services and legal action to collect all fees and costs due the City of Sallisaw. e. Payments received on account will be applied to the oldest outstanding charge on record, including late fees. f. The City of Sallisaw reserves the right to adjust landfill rates and fees as needed without notice to customers. If possible, the City of Sallisaw will notify customers in advance of any rate modifications. g. As a service to our customers, copies of charge tickets will be included in each monthly statement. This is in addition to the ticket copy your driver will receive when exiting the facility. Failure of your company to not collect ticket copies from drivers is not an excuse for nonpayment of incurred charges. Requests for additional copies of tickets already provided may incur additional costs to the customer. h. All drivers are required to sign weigh tickets and obtain a copy before exiting the facility. 7. GUARANTEE OF PAYMENT a. The City of Sallisaw may require the customer to place with the City a deposit for use of the landfill facility. If a deposit is required, it will be based on the estimated tonnage the customer brings to the facility. Additional deposit may be required if tonnage increases. At no time will a deposit be decreased based on decreased tonnage. When a customer ceases use of the facility, all deposits will be applied to any outstanding invoices, with any balances refunded to the customer. b. The City of Sallisaw may require a surety bond be deposited with the City by the customer. The amount of the surety bond will be based on the estimated tonnage the customer brings to the facility. If a customer fails to pay any invoices due, the city may file a claim on the surety bond. Page 4 of 5

5 c. The City of Sallisaw may require the customer make weekly payments on account. This will be based on past payment history and credit ratings of the customer. If weekly payments are required, they must be made prior to Tuesday of each week before continuation of disposal will be allowed. 8. UNACCEPTABLE WASTE: a. The Sallisaw Solid Waste Facility does not accept hazardous waste, free flowing liquids, industrial or off road tires or tires mounted on rims. b. Non-hazardous industrial waste must have prior approval before it is accepted in the facility. c. If customer delivers to our facility any material which does not conform to the definition of solid waste under this agreement or to the requirements of any applicable governmental law, regulation, rule or order, or any special waste not approved for disposal by the City of Sallisaw, Customer shall, at the City of Sallisaw s request, promptly make available a vehicle suitable for transporting the nonconforming material and shall promptly load such nonconforming material on the vehicle and Customer shall promptly remove the nonconforming material from the facility. Customer shall also be responsible for increased inspection, testing, study and analysis costs made necessary due to reasonable concerns of the City of Sallisaw as of the content of the waste following the discovery of potentially unacceptable wastes. I represent that the above information is true and is given to induce the City of Sallisaw to extend credit privileges to the applicant. My company and I authorize all trade references, banks and credit reporting agencies to disclose to the City of Sallisaw any and all information concerning the financial and credit history of my company and/or myself. I agree that I/company will remit payments on account as required in the attached terms and conditions. I agree that I will notify the City of Sallisaw immediately if any billing discrepancies are noted. I have read the terms and conditions stated in this application and agree to all terms and conditions. Customer Signature: Name printed: Title: Date: Sallisaw Municipal Authority Signature: Name printed: Title: Date: Page 5 of 5