Conservice - CheckSammy

A Sustainability Company

Please complete the form to request CS OnDemand Junk Removal for Conservice.
Should your municipal landfill charge for each individual mattress there will be an additional charge on your final bill for $15 per mattress
Customer Support Representative Who Is Placing Order*
First Last
Customer Support Rep Email*
Customer Support Phone Number*
Site & Bulk Pick-up Information
Client Name (company)*
Site Name (property/community)*
Site Contact*
First Last
Site Contact Phone (mobile or landline)*
Site Contact Email*
The Service Required is
Purchase Order # (PO)*
Requested Pickup Date*
MM slash DD slash YYYY
Requested Pickup Time*
Arrival will be within 2 hours of time selected

: HH

MM

AM/PM
List of Bulk items & Location
Please provide details about bulk items to be picked-up and any location specifics
Photos of Items for Pick-up
Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 4 MB, Max. files: 15.
Please provide photos of items to be picked up - the better the visual details of what is to be picked up - the more efficient we can be.
Site Contact & Service Address
Name*
First Last
Phone*
Pickup Location*
Street Address Address Line 2 City State ZIP Code
Billing Details
This request, once the job is complete, will be invoiced to*
Client Name*
Address*
Street Address Address Line 2 City State ZIP Code
Client Billing Email*
Client Phone*
Requesting Entity, if different from Property” (“Buyer”)

By clicking submit, Buyer hereby certifies that Buyer is an authorized representative for the referenced property for which Buyer is submitting this work order (the “Property”). Buyer hast he authority to submit this work order on behalf of the Property, including but not limited to authorization to order the scope of work to be performed under the work order, and (ii) ensure payment for this work. Buyer agrees to pay all invoices in full within 30-days. If Buyer places a work order on behalf of a third-party Property (such Property, a “Third Party Customer”), Buyer will supply CheckSammy with all information required to bill each Third Party Customer for all applicable work orders. CheckSammy will use commercially reasonable efforts to bill Third Party Customers. In the event that a Third Party Customer has not paid a CheckSammy invoice within 120 days of the date of such invoice, Buyer agrees to immediately pay all such invoices in full (including any interest due thereon). Buyer shall pay interest on all late payments at the lesser of the rate of 1.5% per month or the highest rate permissible under applicable law, calculated daily and compounded monthly. Buyer shall reimburse Seller for all costs incurred in collecting any late payments, including, without limitation, attorneys’ fees.