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Office Hours 7:30am to 5pm

tel 303.278.8600
fax 303.277.9705

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City of Golden PAYT Service Request

Please be sure to complete this form by June 30th, 2010 with your choice of containers. If we do not hear from you we will deliver the 96 gallon cart and recycle bin as your initial delivery.


Your Name *

FIRST
****required information

LAST

Daytime Phone Number *


Email Address *



Do you already have an account with EDS?
›YES, I DO
›NO
YOUR ACCOUNT NUMBER

Do you have a City of Golden "Water Bill"?
›YES, I DO
›NO
YOUR ACCOUNT NUMBER

Your Service Address *

Your Billing Address *




I am interested In...
Base Service
Recycling is included in your base service. In an effort to encourage as much recycling as possible you will automatically receive a 96 gallon cart to be serviced every other week.

Base Service – Trash Collection (Please choose only one)
32 Gallon Trash Container $6.57/month

64 Gallon Trash Container $11.03/month

96 Gallon Trash Container $16.87/month


Base Service – Options
Super Saver Plan $5.42/month (32 Gallon Every Other Week)

Extra 96 Gallon Trash Container $7.95/month
How Many Carts?
You must have 96 gallon base service to order the additional 96 gallon cart.)

64 Gallon Recycle Container (Alternate Container Size for Recycling)
If your home absolutely will not accommodate a larger cart or if you have physical limitations that will make it difficult to move the 96 gallon you may choose the 64 gallon option


These charges will be added to your monthly water bill.


PLEASE NOTE: Within the first 90 days of service you will be allowed one exchange in cart size at no cost. After the first three months you will be limited to one exchange in cart size per quarter and may add or cancel carts each six months for an additional charge.


Service Add Ons


Additional Service Options (Please choose as many as apply)
Extra Trash Stickers $2.65 per sticker (Minimum Purchase 5 Stickers)
How Many Stickers?
(There are 5 stickers in each package.)

Green Waste Compost Service $5.95/month (96 Gallon Cart)

Carry Out/Carry Back Service $6.00/month

Carry Back Service $3.00/month

In Drive Service $10.00/month

Beyond Green Program $1.25/month paid annually


Additional service options will be billed individually and separately from your city charges.



Additional Information About You
Please include any additional information you would like to share with or ask us.



Need More Information?
Call our office at 303.278.8600 or email us

















CUSTOMER SERVICE

303.278.8600
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