Hatfields Equipment and Dedication Services Inc. Voice 301 490 4289 PO Box 519 Annapolis Junction, MD 20701 Fax 301 490 5794 Roll Off Cost Agreement 30 yard roll off 22 Ft. Long, 8Ft. wide, 72 inches high $ 525.00 up to 5 tons $ 75.00 per ton over allotted tonnage $5.00 per day after 2 week rental, you must contact office for exchange or terminate. Sign here for 30yd_____________________________ 20 yard roll off 22 Ft. long, 8 Ft. wide, 52 inches tall $ 475.00 up to 3.5 tons $ 75.00 per ton over allotted tonnage $5.00 per day after 2 week rental, you must contact office for exchange or terminate Sign here for 20yd_________________________________ 10 Yard roll off 14 Ft. long, 8 Ft. wide, 42 inches tall $ 300.00 up to 2.5 tons $ 75.00 per ton over allotted tonnage $5.00 per day after 2 week rental, you must contact the office for exchange or terminate Sign Here for 10 yd____________________________________ Customer name:_____________________________ Phone# ___________________ Address:________________________________________________________________________________________________ ________________________________________________________________________________________ Delivery Address:______________________________________________________________________ __________________________________________________________ Customer Fax_______________________________ Customer email____________________________________________ Visa or Mastercard______________________________________________ Exp____/_____ CVV Code(3 digit security code from back of card)_____________ **If you do not want to put credit card information on here you may give it to the office. Unacceptable materials consist of paints, engines, oil, asbestos items, fuel containers, hazardous materials We can accept tires at an extra fee but cannot mix with the trash, they must be separated. Call office for fee. Customer is responsible for any damage to delivery area Do not fill above the top of the dumpster Visa or mastercard required prior to service for payment on delivery and of all other costs incurred Signature required above in acknowledgment of this agreement There is a $75.00 trip charge for containers unable to be delivered or picked up. Any account over 30 days will be subject to interest and attorneys fees. Accounts over 60 days will be turned over to our attorney for collection. A fee of 25% plus interest will be charged. Non payment of any past due amount will be sufficient justification to stop service/work. Updated September 2016
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