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832 833 2467 rshubin@blazingbins.com

Contact Information* Required Information

Pickup Location

Service Location

Additional Information

Job Type *

Service Area *

What day is your trash pick up on? * Monday Tuesday Wednesday Thursday Friday Saturday

What day is your recycling pick up on? * Monday Tuesday Wednesday Thursday Friday Saturday

How many trash bins to be cleaned? *

How many reycle bins to be cleaned? *

Please let us know how you heard about us. *

Gate Code *

False {

Blazing Bins

}

Phone: 832 833 2467

Email: rshubin@blazingbins.com

Address: 2162 Spring Stuebner Road Suite 140-402

Zip/Postal Code: 77389

Repeat On

Week of a month

W1
W2
W3
W4
Last

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Please Select Your Service Below

Pick Service Category

$0.00

Pick Sub Category

BIN CLEANING/TRASH CAN CLEANING

Monthly Cleaning

1 Bin Monthly ,Same 1 Bin Cleaned Every Time (once a month)

1 Bin Monthly

Same 1 Bin Cleaned Every Time (once a month)

$11.50 / Each Visit

Select

2 Bins Monthly,Same 2 Bins Cleaned Every Time (once a month)

2 Bins Monthly

Same 2 Bins Cleaned Every Time (once a month)

$19.50 / Each Visit

Select

3 Bins Monthly ,Same 3 Bins Cleaned Every Time (once a month)

3 Bins Monthly

Same 3 Bins Cleaned Every Time (once a month)

$27.50 / Each Visit

Select

4 Bins Monthly ,Same 4 Bins Cleaned Every Time (once a month)

4 Bins Monthly

Same 4 Bins Cleaned Every Time (once a month)

$35.50 / Each Visit

Select

5 Bins Monthly ,Same 5 Bins Cleaned Every Time (once a month)

5 Bins Monthly

Same 5 Bins Cleaned Every Time (once a month)

$43.50 / Each Visit

Select

Bi-Monthly Cleaning

1 Bin Bi-Monthly ,Same 1 Bin Cleaned Every Time (every 2 months)

1 Bin Bi-Monthly

Same 1 Bin Cleaned Every Time (every 2 months)

$13.50 / Each Visit

Select

2 Bins Bi-Monthly ,Same 2 Bins Every Time (every 2 months)

2 Bins Bi-Monthly

Same 2 Bins Every Time (every 2 months)

$23.50 / Each Visit

Select

3 Bins Bi-Monthly ,Same 3 Bins Every Time (every 2 months)

3 Bins Bi-Monthly

Same 3 Bins Every Time (every 2 months)

$33.50 / Each Visit

Select

4 Bins Bi-Monthly ,Same 4 Bins Cleaned Every Time (every 2 months)

4 Bins Bi-Monthly

Same 4 Bins Cleaned Every Time (every 2 months)

$43.50 / Each Visit

Select

5 Bins Bi-Monthly ,Same 5 Bins Cleaned Every Time (every 2 months)

5 Bins Bi-Monthly

Same 5 Bins Cleaned Every Time (every 2 months)

$53.50 / Each Visit

Select

Quarterly Cleaning

1 Bin Quarterly,Same Bin Every Time (every 3 months)

1 Bin Quarterly

Same Bin Every Time (every 3 months)

$18.50 / Each Visit

Select

2 Bins Quartelry ,Same 2 Bins Cleaned Every Time (every 3 months)

2 Bins Quartelry

Same 2 Bins Cleaned Every Time (every 3 months)

$29.50 / Each Visit

Select

3 Bins Quarterly ,Same 3 Bins Cleaned Every Time (every 3 months)

3 Bins Quarterly

Same 3 Bins Cleaned Every Time (every 3 months)

$40.50 / Each Visit

Select

4 Bins Quarterly ,Same 4 Bins Cleaned Every Time (every 3 months)

4 Bins Quarterly

Same 4 Bins Cleaned Every Time (every 3 months)

$51.50 / Each Visit

Select

5 Bins Quarterly ,Same 5 Bins Cleaned Every Time (every 3 months)

5 Bins Quarterly

Same 5 Bins Cleaned Every Time (every 3 months)

$62.50 / Each Visit

Select

BIN CLEANING/TRASH CAN CLEANING

Monthly Cleaning

Select
$ 0

1 Bin Monthly

$ 11.50 / Each Visit

11.5

Description:

Same 1 Bin Cleaned Every Time (once a month)

1 Bin Monthly ,Same 1 Bin Cleaned Every Time (once a month)

Select
$ 0

2 Bins Monthly

$ 19.50 / Each Visit

19.5

Description:

Same 2 Bins Cleaned Every Time (once a month)

2 Bins Monthly,Same 2 Bins Cleaned Every Time (once a month)

Select
$ 0

3 Bins Monthly

$ 27.50 / Each Visit

27.5

Description:

Same 3 Bins Cleaned Every Time (once a month)

3 Bins Monthly ,Same 3 Bins Cleaned Every Time (once a month)

Select
$ 0

4 Bins Monthly

$ 35.50 / Each Visit

35.5

Description:

Same 4 Bins Cleaned Every Time (once a month)

4 Bins Monthly ,Same 4 Bins Cleaned Every Time (once a month)

Select
$ 0

5 Bins Monthly

$ 43.50 / Each Visit

43.5

Description:

Same 5 Bins Cleaned Every Time (once a month)

5 Bins Monthly ,Same 5 Bins Cleaned Every Time (once a month)

Bi-Monthly Cleaning

Select
$ 0

1 Bin Bi-Monthly

$ 13.50 / Each Visit

13.5

Description:

Same 1 Bin Cleaned Every Time (every 2 months)

1 Bin Bi-Monthly ,Same 1 Bin Cleaned Every Time (every 2 months)

Select
$ 0

2 Bins Bi-Monthly

$ 23.50 / Each Visit

23.5

Description:

Same 2 Bins Every Time (every 2 months)

2 Bins Bi-Monthly ,Same 2 Bins Every Time (every 2 months)

Select
$ 0

3 Bins Bi-Monthly

$ 33.50 / Each Visit

33.5

Description:

Same 3 Bins Every Time (every 2 months)

3 Bins Bi-Monthly ,Same 3 Bins Every Time (every 2 months)

Select
$ 0

4 Bins Bi-Monthly

$ 43.50 / Each Visit

43.5

Description:

Same 4 Bins Cleaned Every Time (every 2 months)

4 Bins Bi-Monthly ,Same 4 Bins Cleaned Every Time (every 2 months)

Select
$ 0

5 Bins Bi-Monthly

$ 53.50 / Each Visit

53.5

Description:

Same 5 Bins Cleaned Every Time (every 2 months)

5 Bins Bi-Monthly ,Same 5 Bins Cleaned Every Time (every 2 months)

Quarterly Cleaning

Select
$ 0

1 Bin Quarterly

$ 18.50 / Each Visit

18.5

Description:

Same Bin Every Time (every 3 months)

1 Bin Quarterly,Same Bin Every Time (every 3 months)

Select
$ 0

2 Bins Quartelry

$ 29.50 / Each Visit

29.5

Description:

Same 2 Bins Cleaned Every Time (every 3 months)

2 Bins Quartelry ,Same 2 Bins Cleaned Every Time (every 3 months)

Select
$ 0

3 Bins Quarterly

$ 40.50 / Each Visit

40.5

Description:

Same 3 Bins Cleaned Every Time (every 3 months)

3 Bins Quarterly ,Same 3 Bins Cleaned Every Time (every 3 months)

Select
$ 0

4 Bins Quarterly

$ 51.50 / Each Visit

51.5

Description:

Same 4 Bins Cleaned Every Time (every 3 months)

4 Bins Quarterly ,Same 4 Bins Cleaned Every Time (every 3 months)

Select
$ 0

5 Bins Quarterly

$ 62.50 / Each Visit

62.5

Description:

Same 5 Bins Cleaned Every Time (every 3 months)

5 Bins Quarterly ,Same 5 Bins Cleaned Every Time (every 3 months)

Your Information

Taxes

Federal Tax (0.00 %):

State Tax (0.00 %):

City Tax (0.00 %):

County Tax (0.00 %):

Special Tax (0.00 %):

Total (8.250 %):

0.00

Note

Job Information

Service Area

What day is your trash pick up on?

What day is your recycling pick up on?

How many trash bins to be cleaned?

How many reycle bins to be cleaned?

Please let us know how you heard about us.

Gate Code

Schedule

From:

To:

Items

Services

Repeat Every Week

Note

Repeats On

On The Month Of

Week of Month

1
2
3
4
Last

Day of Week

Interval Week(s) Every 6th week or 10th week

Day of Week

On The Day Of You put the day number of a month

Ends On

After Occurrences

Booking Summary

Zone:

Job Type:

Cleaning requested on:

Next Billing Date:

Discount	$ 0.00
Sub Total	$ 0.00
Tax	$ 0.00
Federal Tax (0.00 %)	$0.00
State Tax (0.00 %)	$0.00
City Tax (0.00 %)	$0.00
County Tax (0.00 %)	$0.00
Special Tax (0.00 %)	$0.00
TOTAL	$ 0.00
Processing Fee	$ 0.00
Payable	$ 0.00

Payment Details

You will pay $0.00

Same As Service Location

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Amount Due 0.00

You have to pay $(100.00%) for Down Payment

Same as Customer address.

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Thank you for choosing Blazing Bins. We will be send an email once we have scheudled your service. If you have any quesitons or concerns please email us at info@blazingbins.com

I am sorry we are having an issue locating your address please contact us.

Contact Information* Required Information

Pickup Location

Service Location

Additional Information

Repeat On

Week of a month

Select the Correct Zone

Please Select Your Service Below

Pick Service Category

Pick Sub Category

1 Bin Monthly

Same 1 Bin Cleaned Every Time (once a month)

$11.50 / Each Visit

2 Bins Monthly

Same 2 Bins Cleaned Every Time (once a month)

$19.50 / Each Visit

3 Bins Monthly

Same 3 Bins Cleaned Every Time (once a month)

$27.50 / Each Visit

4 Bins Monthly

Same 4 Bins Cleaned Every Time (once a month)

$35.50 / Each Visit

5 Bins Monthly

Same 5 Bins Cleaned Every Time (once a month)

$43.50 / Each Visit

1 Bin Bi-Monthly

Same 1 Bin Cleaned Every Time (every 2 months)

$13.50 / Each Visit

2 Bins Bi-Monthly

Same 2 Bins Every Time (every 2 months)

$23.50 / Each Visit

3 Bins Bi-Monthly

Same 3 Bins Every Time (every 2 months)

$33.50 / Each Visit

4 Bins Bi-Monthly

Same 4 Bins Cleaned Every Time (every 2 months)

$43.50 / Each Visit

5 Bins Bi-Monthly

Same 5 Bins Cleaned Every Time (every 2 months)

$53.50 / Each Visit

1 Bin Quarterly

Same Bin Every Time (every 3 months)

$18.50 / Each Visit

2 Bins Quartelry

Same 2 Bins Cleaned Every Time (every 3 months)

$29.50 / Each Visit

3 Bins Quarterly

Same 3 Bins Cleaned Every Time (every 3 months)

$40.50 / Each Visit

4 Bins Quarterly

Same 4 Bins Cleaned Every Time (every 3 months)

$51.50 / Each Visit

5 Bins Quarterly

Same 5 Bins Cleaned Every Time (every 3 months)

$62.50 / Each Visit

Your Information

Taxes

Note

Job Information

Schedule

Items

Services

Repeats On

Ends On

Booking Summary

Zone:

Job Type:

Cleaning requested on:

Next Billing Date:

Payment Details

Card Information

Amount Due 0.00

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