Fillable LANDFILL CREDIT ACCOUNT APPLICATION Solid Waste Baldwin County (Baldwin County Commission)

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LANDFILL CREDIT ACCOUNT APPLICATION Solid Waste Baldwin County (Baldwin County Commission)

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LANDFILL CREDIT ACCOUNT APPLICATION
Baldwin County
Solid Waste
Phone: 251-972-6878
Fax: 251-580-2582
Magnolia Landfill
15140 County Road 49
Summerdale, AL 36580
Phone: 251-972-8574
MacBride Landfill
14200 County Road 64
Loxley, AL 36551
Phone: 251-972-8508
Bay Minette
Transfer Station
42901 Nicholsville Road
Bay Minette, AL 36507
Phone: 251-580-1898
Customer Name
Phone
Fax
Billing Address
City
State
Zip Code
Physical Address
City
State
Zip Code
Phone
Cellular
E
-
Mail
Accounts Payable Contact
Phone
Cellular
E
-
Ma
il
TAX ID: ____________________________________
Estimated Disposal Material Generated: TONS/YEAR
Type of Disposal Material Being Transported:
Are you currently, or have you in the past, done business with Baldwin County Solid Waste?
Yes No
Date Business Started: (mm/yy) _________________________
I do hereby state, that I am authorized to arrange for the handling and disposal of the above referenced materials. I am
further authorized to commit the above noted firm to pay all costs associated with disposal of said materials.
Name: Title:
Signature: Date:
__________________________________________________________________________________________________
DO NOT WRITE BELOW THIS LINE / OFFICE USE ONLY
Approved by _________________________________________________ Date____________________
Terri Graham, Development and Environmental Director
Account Number
Credit Limit
Date Opened
Opened by
click to sign
signature
click to edit
LANDFILL CREDIT ACCOUNT APPLICATION
Trade References: (No Financial Institutions or Credit Card Companies)
Company Name:
Contact:
Address
City State Zip
Phone Number:
Fax:
Company Name:
Contact:
Address
City State Zip
Phone Number:
Fax:
Company Name:
Contact:
Address
City
State Zip
Phone Number:
Fax:
If credit is granted, I/we promise to pay bills when rendered. I/we understand all invoices are payable 15 days from receipt of invoice.
In the even payment is not made and my/our account is referred to a collection agency or attorney, I/we will pay cost of collection. If
legal action is required, I/we will pay reasonable attorney’s fees resulting from such action. I/we authorize the above listed trade
references to release to Baldwin County Solid Waste any credit or financial information that Baldwin County Solid Waste may request.
I/we acknowledge that the extension of credit will be at the sole discretion of Baldwin County Solid Waste.
Commercial Account Late Fees: Payment is due by the 5
th
of each month. A two percent (2%) late fee with a minimum late fee of
$10.00 will be imposed on all commercial charge accounts that payment is not received by the 15
th
of the month.
Return Check Policy: An NSF fee of $30.00 will be added to your account on all return checks.
Terminating Account: The customer is responsible for notifying Baldwin County Solid Waste to close their account.
Please Describe Your Vehicle(s):
DRIVER
VEHICLE NUMBER
MAKE OF VEHICLE
LICENSE NUMBER
*Baldwin County Solid Waste (BCSW) requests that your account name/number be displayed on your vehicles and/or trailers to ensure
charges are posted to account correctly. If Baldwin County Solid Waste is unable to positively identify your driver or vehicle we will
require written notification from your account contact prior to disposal.
**BCSW will store weights for customer vehicles. However, at any given time BCSW may ask customers to reweigh vehicles
to ensure accountability for both parties.
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LANDFILL CREDIT ACCOUNT APPLICATION Solid Waste Baldwin County (Baldwin County Commission)

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Completed 5 August 2020

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