2. CITY OF PORT ARTHUR
   Commercial Container Service Contract
4. Complete and Return this completed contract to activate service and update customer records.
   The Water Utilities Department, Customer Service Division, in its effort to update commercial customer records, requests that you complete this container service contract. Please, return the completed contract, including a copy of your driver's license identification.
6. Customer Information
8. Customer Status*
   -- Select One --New CustomerContract RenewalPrice ChangeService Change
10. Name*
11. Email Address
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Fax Number
22. Choose Company Type from list below:*
    -- Select One --ProprietorPartnershipCorporation
23. State of Incorporation
25. Name of Principal*
26. Title*
30. Service Location
32. Location Name*
33. Email Address
35. Address*
37. City*
38. State*
39. Zip Code*
41. Phone Number*
42. Fax Number*
44. Service Contact*
45. Title*
47. Effective Date of Service/Change*
51. Financial
53. Open/Close Gate Fee per pick up

    1. Yes
    2. No

    City of Port Arthur charges $10.00 for an Open/Close gate fee
54. Number of Pickups Per Week*
55. Customer Initials*
57. Container Size*
    -- Select One --2 yard4 yard8 yard
58. Monthly Service Fee
59. Customer Initials*
61. City Regulations for Containers:
    1. No wood, bricks, or metal is allowed in the container.
    2. No appliances, brush, or building materials of any kind.
    3. City of Port Arthur is not liable for any damages that occur on the owners premises.
63. Customer Signature
64. Date
66. If not weekly, then every:
    -- Select One --2 weeks3 weeks4 weeks5 weeks6 weeks
68. Contract for Refuse is needed to complete documentation required.
    Contract for Refuse is located at Utility Billing office.
    City Hall Annex
    First Floor
    Utility Billing
    444 4th Street
    Port Arthur, TX 77642
70. Please see link below for commercial container rates per City of Port Arthur.
    http://tx-portarthur.civicplus.com/303/Commercial-Containers---Dumpsters
Leave This Blank:


72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit Submit and Print

* indicates a required field