Bulk Pickup Form

First Name*

Last Name*

Address*

Email Address*

Date*

I understand that Bulk Items will be picked up on the third Thursday of each month and pick-up requests must be submitted no later than the Friday before. If a request is made after the deadline the items will not be picked up by Republic Services. The request will be added to the pick-up list for the following month.*

Yes

I understand Items should not be placed on the street earlier than 24 hours prior to the pick-up date.*

Yes

I understand that the maximum amount of bulk items that may be picked up is 3. If there are more than 3 items Republic Services may not pick up any items.*

Yes

I understand that Republic Services will not pick up brush, tires, batteries, freon, paint, shingles, or other hazardous materials.*

Yes