Application for Dumpster Service

Application for Dumpster Service
Date *

Month Day Year
Date
Account Number

Applicant Information
Name of Individual or Business *
Type of Business *

Commercial Residential
Service Address *

Street Address

Apartment #

City

Postal / Zip Code
Mailing Address (if different)

Street Address

Street Address Line 2

City State

Zip Code
Previous Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Do you need to transfer services from previous address?

Yes No
Previous Account Number
Service Request Start Date *

Month Day Year
Date
Disconnect Date for services at previous address

Day Month Year
Date
President or Legal Representative
Federal Tax ID #
Type of Business

Corporation Sole Proprietorship Partnership Other
Phone Number *
Fax Number
Your E-mail Address *
Driver License or ID #
State
Government Identification *

Browse Files
Please attach one form of government-issued picture identification. Cancel of
CONFIDENTIAL: Please choose a 4-digit PIN to verify account information

Location Point of Contact

Please provide a point of contact where the dumpster will be located.
Name *

First Name Last Name
Phone Number *

Area Code Phone Number

Dumpster Service
Dumpster Options for Businesses

3 Yard 4 Yard 6 Yard 8 Yard
Dumpster Pick Up Schedule
Choose 1-6 times per week.
Open Top Container Options for Rent

20 Yard 30 Yard 40 Yard
Location of Dumpster
Rates for these services can be found online http://www.ci.greenville.tx.us/217/Garbage-Collection-Recycling

The scheduled delivery day could take up to 3 business days, weather permitting.

Please be advised that there could be possible delays during summer construction period.

Credit Check / Deposit Information
Deposits are based on credit history from Experian. Acceptance for commercial accounts will cost a one-time $20 fee, there is no charge for residential credit checks and allows GEUS to check once annually.
Credit Check

Accept Decline
Failure to choose one option could delay application process.

Deposit Information
Federal Tax ID#
Required for business credit history.
Social Security Number
Required to pull personal credit history.

Agreement
The Applicant, whose signature appears below, applies to GEUS for some or all of the following services: Electric, Water, Sewer, Garbage, Cable TV, Internet and other services incident thereto, to be supplied at the address herein described, and upon request, at any other local address to which Applicant may move. The Applicant agrees to pay for said services as bills are rendered therefore, in accordance with the rates, rules and regulations as provided in the City Charter or by City Ordinances as now existing or as may be enacted and in effect at the time of delivery, regardless of who the consumer might be. The Applicant further agrees to release and discharge said GEUS or the City of Greenville from a liability for damages suffered (1) by reason of electric or water currently furnished to the premises, or (2) by reason of interruption, discontinuance or disconnection of service hereunder from any cause other than negligence by GEUS or the City of Greenville or (3) by reason of the condition, maintenance, location, or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which services are furnished and delivered. Service requests for disconnections will be processed within 2 business days.

Applicant agrees to follow all current or as amended policies and procedures established in the Greenville City Ordinances and GEUS Service Policy. Such policies and procedures can be found on the links provided.

Greenville City Ordinances

GEUS Service Policy (PDF)

My signature is an acknowledgement that this is a contract and that I personally agree to make payments and am guaranteeing payment of all sums due and owing on behalf of myself and anyone using services at this address. Additionally, by submitting this form via electronically, I agree to conduct business electronically and an electronic signature is binding on me. If I move from this address, it is my responsibility to contact GEUS to terminate this account. I will remain responsible for the amounts owed on or services charged to this account until such time as I terminate this account.
Applicant Signature *

First Name Last Name
Date *

Month Day Year
Date
Applicant E-Signature

Clear
An email with your completed application will automatically be sent to the email address you provided.

Should be Empty:

Application for Dumpster Service

Applicant Information

Location Point of Contact

Dumpster Service

Credit Check / Deposit Information

Agreement