Roll-Off Container Rental Form

Roll-Off Container Rental Form

Please complete the form below.
Your registration will be verified prior to your delivery.
Full Name

First NameLast Name
Company
Company Name
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Delivery Date

MonthDayYear
Pick Up Date

MonthDayYear
Number of expected dumps
PRICING

$485 + sales tax per dump

$10 per day after initial seven day rental

$50 per additional ton over 5 tons

$50 relocation fee if roll off needs to be moved from original location

1.5% interest monthly on accounts/invoices past 30 days
- Initial cost will be charged upon delivery of container(s)
RENTAL AGREEMENT
- Customer will acquire any necessary permits if required.
- Customer will provide unobstructed access upon delivery and pick up.
- Customer will assume care of equipment including collision and fire damage. Fire should not be allowed to burn inside of containers.
- Customer will assume responsibility of any property damage
  - It is recommended to provide plywood or some type of protective material if customer desires a container to be placed on a driveway.
- Customer will bear responsibility and liability for any loss or damage to container during the rental period.
TERMS

American Disposal Systems, LLC is not responsible for damages arising from placement of container to pavement, curbing, driveway, lawn, landscaping, sprinkler system, trees, branches, sidewalk, turf underneath or within path of drop for delivery or pick up.

UNACCEPTABLE ITEMS

$100.00 Fine Minimum: Appliances, Asbestos, Barrels, Batteries, Chemicals, Lawnmowers, Motors, Oil, Paint Cans, Tires, Hazardous and Waste...
Any Special request upon delivery?
Payment Method
Pay by

CheckCashCredit Card

Orders

20 yard roll-off container$485.00

Quantity

Subtotal $0.00Tax $0.00Total $0.00

Credit Card

Should be Empty: