Service Agreement Form Service Agreement Nordic Waste Services LLC's werecyclefood.com service agreement Customer Contact InfoName* First Last Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code SERVICE SPECIFICATIONSService*Select one of the following.Drop Off ServiceCurbside Pick Up ServiceAdditional Bucket Price: $10.00 Quantity: Combo Discount of $10/mo with Trash Service Price: -$10.00 Quantity: Monthly total to be paid by recurring credit/debit payment. Information will be collected securely during confirmation phone call. $0.00 Promo Code / Referred By What goes in the bucket? If it is food, or was food, in it goes! Vegetables, Fruits, Citrus (please remove the sticker) Breads, Grains, Seeds Meat, Dairy, Bones, ShellsCoffee Grounds, Filters, Tea Bags (without staples)Food Soiled Paper and Cardboard Products What doesn't go in the bucket? If you didn't eat it, or wouldn't eat it, keep it out! Plastic & Styrofoam • Metal • Glass Pet Waste or Diapers • Chemicals Plastic Wrap, Twists, Tabs, Stickers, Rubber BandsAny Inorganic Materials Brush, Leaves, Sticks (yard waste) Acknowledgement* I understand what goes in the bucket.TERMS OF ACCEPTANCE AND SIGNATUREIt is understood by both parties that this service agreement will automatically renew each month. Written notice of termination by either party must be received 30 days prior to recurring payment or payment due date. An email notice will suffice, but does require a response back from other party to ensure receipt and to authenticate the notice. *Service rate changes may occur with 60 day notice to the customer. THE UNDERDESIGNED INDIVIDUAL SIGNING THIS AGREEMENT ON BEHALF OF CUSTOMER ACKNOWLEDGES THAT HE/SHE HAS READ AND UNDERSTANDS THE TERMS AND CONDITONS OF THIS AGREEMENT AND THAT HE/SHE HAS THE AUTHORITY TO SIGN ON BEHALF OF THE CUSTOMER. Electronic Signature* First Last I understand that typing my name in the above box and clicking SUBMIT constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.Date* Date Format: MM slash DD slash YYYY Please note: Service will not begin until we speak with you by phone to answer any questions, solidify a start date, and receive your credit card information. Expect a call from us soon!