Municipality Onboarding – Tough Stuff Recycling

Municipality Name(Required)

Billing Contact Name(Required)

First Last

Billing Contact Email(Required)

Billing Contact Phone(Required)

Billing Contact Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Per Unit Rate for Subsidized Pick Up

Per Unit Rate for Subsidized Drop Off

Per Unit Rate for Standard Pick Up (Not subsidized)

Per Unit Rate for Standard Drop-Off (Not subsidized)

Per Unit Rate for Express Pick Up (Not subsidized)

Will you offer Bulk Pick-Up/Drop-Off Options?

Yes

Bulk Pick Up Rate per range

ie: 30-50, 51-70, 71 -90 etc.

Bulk Drop off Rate per range

ie: 30-50, 51-70, 71 -90 etc.

Is there a Cap? ( Maximum # of Mattresses per cycle)

Yes

Annual Mattress Cap

Per Household Mattress Cap

ie: 1 Jan - 31 Dec

Cycle Start

Cycle End

Pick up Frequency

Pick-Up Day

Pick-Up Start Time

Pick-Up End Time

Zip Codes under Municipality

Zip Code

Drop off location Name

Drop off location Address

Drop off location Address 2

Drop off location City

Drop off location State

Drop off location Zip

Zip Codes within Municipality

This field is for validation purposes and should be left unchanged.