Dumpster Rental Agreement

Dumpster Rental Agreement

Complete the information below to schedule your dumpster rental, select your dumpster size, review the rental terms, and submit payment
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requested Delivery Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year*Requested delivery date is subject to availability and is not confirmed until Tellus Dumpsters confirms scheduling and payment has been received.
Dumpster Placement Instructions

Rental Terms & Authorization

Please review the following requirements before completing your rental. These terms help prevent unexpected charges and ensure your dumpster can be safely serviced.
By completing this agreement, I authorize Tellus Dumpsters to store payment and charge card on file for additional amounts incurred under this rental agreement. These may include excess weight, additional rental days, tire and mattress disposal fees, dry-run/failed-service fees, prohibited-material charges, and other charges specifically permitted by this agreement.
ALLOWED MATERIALS
Household junk • Furniture • Construction debris • Wood • Drywall • Roofing materials • Yard debris • Other non-hazardous solid waste

PROHIBITED MATERIALS
Hazardous materials • Paints and liquids • Chemicals • Oils and fuels • Batteries • Propane tanks • Asbestos • Medical waste • Flammable or explosive materials • Other regulated or hazardous waste

RENTAL REQUIREMENTS
Do Not Overfill: Do not load above top of dumpster.

Access for Service: Customer must provide clear and unobstructed access for delivery and pickup.

ADDITIONAL FEES

Credit Card Payments: 3.1% Fee

Tires: Tires are subject to an additional disposal fee of $40 per tire.

Mattresses: Mattresses are subject to an additional disposal fee of $100 per mattress.

Dry Run / Unable to Service: A $150 fee may apply if our driver cannot complete scheduled service because of blocked access, unsafe conditions, or circumstances within the customer's control.
Rental Terms Acknowledgment
Authorization for Additional Charges

Please review and accept the payment authorization below.
Additional Charges Authorization

Select Your Dumpster & Sign

Select your dumpster size, enter your payment information, and sign below to complete your rental request.
A 3.1% card processing fee will be added to all card payments.

Select Your Dumpster Size

10-Yard Dumpster

• Includes 1.5 Tons

• 7 Day Rental ($10 per additional day)

• Approximate Dimensions-

10' L x 7.5' W x 3' H

$350.00

20-Yard Dumpster

• Includes 3 Tons

• 7 Day Rental ($10 per additional day)

• Approximate Dimensions-

18' L x 7.5' W x 4' H

$450.00

30-Yard Dumpster

• Includes 4 Tons

• 7 Day Rental ($20 per additional day)

• Approximate Dimensions-

22' L x 7.5' W x 5' H

$550.00

Subtotal

Tax

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Agreement & Signature

Please sign below to confirm your acceptance of the rental agreement.
Customer Signature

By signing above, I confirm that the information provided is accurate and that I have read, understood, and agree to the terms of this Dumpster Rental Agreement, including the rental price and applicable additional charges.
Should be Empty:

Dumpster Rental Agreement

Rental Terms & Authorization

Authorization for Additional Charges

Select Your Dumpster & Sign

Select Your Dumpster Size*

Agreement & Signature

Select Your Dumpster Size