Mercy Please complete the form to request CS OnDemand Junk Removal for Mercy.Should your municipal landfill charge for each individual mattress there will be an additional charge on your final bill for $15 per mattressCustomer Support Representative Who Is Placing Order* First Last Customer Support Rep Email* Customer Support Phone Number*Community Details & Service RequiredThe Service Required is*Junk RemovalEviction Move Out (furniture & appliances only)Trash-Out (full clean out to broom clean)Community Name* Community Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please Specify Unit Number for Service Number of BedroomsOne (1)Two (2)Three ()Approximate Sq. Ft. of UnitSpecial RequirementsDoes your state have any specific staffing requirements for evictions or trashouts - if yes please provide detailsCommunity Contact & Pickup RequestCommunity Contact Name* First Last Community Contact Phone (mobile or landline)*Community Contact Email* Requested Pickup Date* MM slash DD slash YYYY Requested Pickup Time*Arrival will be within 2 hours of time selected : Hours Minutes AM PM AM/PM List of Bulk items & LocationPlease provide details about bulk items to be picked-up and any location specifics Photos of Items for Pick-upPlease 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.Drop files here or Select filesAccepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 4 MB, Max. files: 15. Billing DetailsOnce the job is complete, the job will be invoiced to*MercyBy clicking submit, I hereby certify that I am an authorized representative for the referenced property for which I am submitting this work order (the “Property”). I have the 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. I agree to pay all invoices in full within 30-days.