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2. Litter Receptacle Reservation Request For Special Events:
4. Name of Event*
5. Date of Event*
6. Time of Event*
8. Location The Event Is Taking Place:*
10. Please provide a brief description of the event:*
12. Estimated number of attendees:*
13. # of Receptacles Needed:*
14. Who's servicing the receptacles?*
16. Name of Event Coordinator:*
17. Name of Organization Hosting The Event:*
19. Borrowers Address:*
21. Phone Number*
22. Email Address*
24. Date & Time Borrower Wants To Pick Up The Receptacles? *
25. Date & Time Borrower Will Return The Receptacles? *
27. Best Practices:

    
    

    • ALWAYS make sure you have a receptacle on each side of the street. 

    •  

    • Optimal receptacle placement if possible is 100-200 feet apart.

    •  

    • Receptacles should be monitored during the event encouraging attendees to dispose of their litter properly by letting them know receptacles are available.

29. Electronic Signature Agreement*

    Terms and Conditions: 

     

    Borrower agrees to the following-

     

    
    

    2. 1. The sole permissible use of the litter receptacle is the collection of litter during special events/parades.

    3. 
       

    4. 3. Make arrangements with Solid Waste to place an open-top container(s) to properly dispose of all bags of litter collected at your event.  Arrangements must also be made with Solid Waste to pick up the open-top container after the event. 

    4. 3. To be responsible for all costs of handling, loading, set up, and transportation to and from KOB storage facility located at 816 W. 42nd behind the Household Hazardous Waste Facility.

    5. 
       

    6. 4. To provide all materials and labor necessary for proper set-up and use of receptacles at the designated location(s) set forth herein.  

    6. 5. To properly maintain receptacle(s), including cleaning the receptacle of any spilled beverages or other materials prior to return.

    7. 
       

    8. 6. To return receptacle(s) in the condition in which it was received by the borrower, with normal wear and tear accepted, and free of contamination, on or before the date specified in the MOU (memorandum of understanding) along with any unused liners. The return date may not be extended without express permission from KOB. 

    8. 7. To complete necessary reporting requirements as found on the back of this document. Failure to report results may jeopardize the ability to borrow in the future. 

    9. 8. The receptacles shall not be modified, altered, or transferred to a third party without express permission of KOB. 
       

    10. 9. To permit KOB access to the location set forth in the MOU for purposes including (but not limited to) inspection and retrieval of KOB property. 

    11. 10. To indemnify and hold harmless Keep Odessa Beautiful, its officers, agents, and employees from any and all claims that may arise from personal injury, damages, losses, or expenses borne from using or misusing the receptacles.

    12. 
        

    13. 11. To reimburse Keep Odessa Beautiful (hereinafter as ‘KOB’) if the litter receptacle (s) is/are lost, or damaged, or if repair is impractical.

    
    

    Fees:

    • The replacement cost per receptacle is $100. 
    • There will be a $15 maintenance fee per receptacle. Payable prior to the event.
      • Make check payable to "Keep Odessa Beautiful".
      • Pay using PayPal:  https://www.paypal.com/fundraiser/charity/2033441.
    • If item #5 is not met there will be an additional $25.00 fee per receptacle assessed upon return.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
31. Electronic Signature
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field