Bin Owner Registration | QuickPick Waste Management Services

1. Customer Details

Full Name

Phone Number

Alternative Contact

Email Address

House / Location

GPS Address

Landmark

2. Service Information

Service Type

Residential Commercial Hostel

Your Bin Size

120L 240L

Collection Frequency

Every 2 days 3/4 days 4/5 days Weekly Bi-Weekly Monthly

Preferred Collection Time

3. Payment Information

Payment Method

Cash Mobile Money Bank Transfer Other

Payment Plan

Monthly Weekly On Pick-Up Other

Account / Reference

4. Penalties Clause

Failure for QuickPick Waste Management Services to carry out duty after 72 hours of agreed service collection time or call, shall attract a penalty of 25% refund or subtraction from service payment, except in cases of accidents, rain, and related health problems affecting field agents.

Failure by customers to fulfill payment obligations consistently for 3 months constitutes automatic contract termination and legal action may be taken to recover service payments with interest through our legal aide.

5. Declaration & Signature

I hereby declare that the information provided is accurate and I agree to abide by the terms and conditions of QuickPick Waste Management Services.

Customer Full Name

Date

Customer Signature

6. Registration Confirmation

Registration Date

Customer Signature

7. Official Use Only

Customer ID

Assigned Route / Area

Sales Officer Name

Date

Notes