Contract & Payment Authorization Form
Contact Name: Company Name: Address: Primary Phone: Fax: Cell: Email:
Name: Company Name: Phone: Email: Address:
Monthly Billing Date: Payment Method:
Bank Name: Routing Number: Account Number:
Credit Card: Exp: CCV:
1. The Company agrees to supply to the Customer, and the Customer agrees to take from the Company exclusively during the terms of this agreement, all of the Company's refuse and recyclable materials service requirements.2. A. SERVICES RENDERED: WASTE MATERIALS. Customer grants to Company the exclusive right, and company shall furnish equipment and services, to collect and dispose of and/or recycle all Customer's Waste Materials. Customer represents and warrants that the materials to be collected under this Agreement shall only "Waste Materials" means all non hazardous putrescible.B. Such wastes are found to be hazardous, as defined by the Solid Waste Commission, the customer shall be liable for any penalties or damages assessed against the collector resulting therefrom.C. The initial service shall be for the type of equipment and on the basis shown herein, but shall change from time to time if the Customer's needs shall increase or decrease in which case adjustments will be made at prevailing prices at the time of such change in Customer's needs.3. The Customer agrees to pay monthly the total monthly service charge then in effect which initially shall be shown above. The total monthly service charge for any month shall be the sum of the monthly service charges for the service supplied. No credit shall be deducted for vacation or holidays, it being understood that such holidays have been taken into account in arriving at the monthly charge.4.A. CHARGES: PAYMENTS: ADJUSTMENTS. Customer shall pay for the services and/or equipment (including repair and maintenance) furnish by Company. as adjusted hereunder, within ten (10) days of the date of Company's invoice. Customer shall pay a service a service charge on all past due amounts accruing from the date of the invoice at the rate of (1 1/2%) per amount or, if less, the maximum rate allowed by law.B. It is further agreed between the Company and the Customer, that the Company reserves the right to increase its service charges under this agreement at any time by giving the Customer sixty days written notice thereof: however, in the event Customer refuses to agree to any such increase, Customer shall have the right to terminate this agreement by giving the Company thirty (30) days written notice of such termination prior to the effective date of such increase.5. The Customer agrees that in the event the dumping site used to dispose of the Customer's refuse increases its disposal rates, said increased cost will immediately be added to Customer's monthly service charge. The Customer shall not have the right to terminate this agreement because of a dumping site increased cost rate adjustment.6. The Company shall maintain Workmen's Compensation for its employees and adequate Motor Vehicle Liability Insurance. The Company is not responsible for personal injuries to any non-employee loading refuse into the vehicle.7. RIGHT OF FIRST REFUSAL. Customer grants to company a right of first refusal to match any offer relating to services similar ti those provided hereunder which Customer receives (or intends to make) upon termination of this Agreement for any reason and Customer shall give company prompt written notice of any such offer and a reasonable opportunity to respond to it.8. Company shall not be responsible for damage to Customer's or other driving surface resulting from the end of Company's vehicles servicing the equipment location designated by Customer. Customer shall provide unobstructed access to the equipment on the scheduled collection day. Customer shall pay, if charged by Company, an additional fee for any service modofocations caused by or resulting from Customer's failure ti provide access. Company shall not be responsible for any damage to Customer's property, including pavement, surface or curbing, resulting from Company's provision of service hereunder.9. Container is not to be loaded above water level.10. It is further agreed that if the Customer no longer requires any collection and disposal services for its waste materials through discontinuance of its business, relocation outside the area which the company provides collection service, or similar reason, Customer may terminate this Agreement upon written notice to the Company at least thirty (30) days prior to the intended termination date, upon payment of all amounts due to the Company.11. This Agreement shall begin at the indicated date of signature.12. This Agreement represents the entire understanding and agreement between the parties hereto: and supersedes any and all prior agreements, whether written or oral, that may exist between the parties regarding same.13. The parties here to agree that in the event of such a breach or termination of this Agreement by the Customer, the Company shall receive as liquidated damages and not as penalty an amount equal to the total of 30% aggregate monthly service charge then in effect for the balance of the term of this agreement, together with all costs including reasonable attorney's fees incurred by the Company in enforcing its rights hereunder.14. This agreement shall by binding upon and shall inure to the benefit of the successors, assigns and personal representatives of the representative parties hereto and the Customer hereby expressly consents to the assignment of this agreement by the Company to any successors or purchasers of the whole or any part its business and expressly consents to be bound by all of the terms herein to any which successors or purchasers, or to any corporation ir entity affiliated with Countywide Carting LTD / JL Trucking without Customer's consent.15. It is understood that if the Company's usual operations are interrupted, or if the service herein provided for is delayed or postponed by reason of acts of God, strikes, lockouts or industrial disturbances, wars, blackouts, riots, arrests, explosions, fires, accidents to machinery, closure and unavailability of usual disposal sites, or any other cause not within the control of the Company, the Company shall not be answerable or liable in damages for any such postponements or delay.16. Term. The initial term ("Term") of this Agreement is thirty six months from the effective Date set forth above ("initial Term") This Agreement shall automatically renew thereafter for additional terms of twelve (12) months each ("Renewal Term") unless either party gives to the other party written notice of termination at least ninety (90) days, but not more than one hundred eighty (180) days, prior to the termination of the then-existing term.
I hereby agree to the terms and conditions on behalf of set forth above and I have chosen to execute this on the date below on behalf of .
Leave this empty:
Your legal name
Your email address
Signed by Morris Jacobowitz Signed On: January 19, 2023
If you have questions about the contents of this document, you can email the document owner.
Document Name: Contract & Payment Authorization Form
Agree & Sign