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- ~ ACCOUNT INFORMATION
1800 BrnadwRy, Kerrv0)r. Tesas T80t8 (S30) X6.6050
- - t NA.:~?~.~_ Refirrad B?:
~ GENERAL Bill Ta
. II~iF08MA~N amr~y ~p~,_T~~ ~ereo~a.
'' ~ AddreM: ~L[ LL i'~C~~~`/ SF1~ Number.
'per-. ter: state: T~-Zip Coda: 7~C0~
G Denver Toe ~
. ~P~l- Contact
Name: person:
Mgt l'bons
~~ Number:
Citq: State: Zip Code:
SPECIAL SET
II~ISTRUCTIONS DUMPSI'F.R:
r::. .
v~
SERVICE Route- Start Dste:
SPECIFICATIONS ~ w _
Noe~_ Sis,e:~, ra. ~ ~~
Serial No.: ~ :.
- ~
~: -
scHEDVLE Monthly Flat Rate Ch,artte a -yr~ fir---= . . _.
©F CHARGES '-- -- --`-~
Bq signing this form, the customer and oompanq agree to these terms and those set 6~rth in the
Dempster Dumpe .Service Guidelines. -- ~ _ .
;r
_ DUM DUMPERS, INC: • "• ~ ~`
nscomes s S ~aaaue - K :: Date ~ : _. .: _ -: A~eat ~.. -~~-~ `- Date " • - -~:
•- .~ .