Parrett Mountain Reclamation Facility Customer Agreement

The Parrett Mountain Reclamation Facility is owned and operated by The Saunders Group and managed by The Saunders Company.
Customers will be e-mailed a monthly bill with net 30 terms. Payments should be made by check to The Saunders Group or via ACH.

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Name: *

Address: *

Name of company/contractor: *

Company Address: *

Material Source: *

Material Type *AsphaltBrickBuilding BrickDirtConcreteRockSandSoil

Company Name: *

Company Mailing Address: *

City: *

State: *

Zip Code: *

Contact Name: *

Email: *

Phone Number: *

Insurance Company: *

Policy Number: *

Fax Number:

Drivers License Number: *

Plate Number: *

Signature *

Date Signed *

Submit

By submitting this form I agree that I have read and understand all information above and agree to adhere to all conditions stated above. I authorize The Saunders Company to verify the above information, including the insurance and licenses provided.