Please fill out the form and submit for your Free Quote: Name: * Address: City: * State: Telephone Number: * Work Number: Email Address: * When do you need our services? Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Is this an apartment building? Yes No If so what floor do you live on? Is there an elevator in your building? Yes No How did you hear about us? (example: yahoo) Is this an estate clean-out? Yes No Is this a debris or rubbish removal? Yes No Is this a garbage removal? Yes No Is this a furniture disposal? Yes No Items Being Removed Please enter the number of each item next to the item. baby stroller baker’s rack BBQ grill bed (bunk) bed (twin) bed (queen) bed (king) dinette bicycle bookcase buffet cabinet (china) cabinet (curio) chair (arm) chair (child’s) chair (high) chair (wing back) chair (overstuffed) chair (rocker) chaise lounge chest (bachelor) chest (cedar) chest (toy) computer crib desk (small) desk (large) desk (office) dinette set dishwasher dresser (1-5dr.) dresser (5-10dr.) dresser (vanity) dryer (clothes) entertainment center filing cabinet freezer (2-10 cu.ft.) freezer (1-15 cu.ft.) freezer (16+cu.ft.) grandfather clock ironing board ladder (6′) ladder (8′) lamp lawn mower dishwasher metal shelves microwave mirror – small mirror – large outdoor swing/gym piano/organ play pen refrigerator (1-6cu.ft.) refrigerator (7+cu.ft.) refrigerator (11cu.ft.) rug (small) rug (area) sewing machine sofa (loveseat) sofa (3+cushions) sectional / sleeper stereo stool stove table (card) table (end/coffee) night stand table (ping pong) table (pool) tool chest (large) TV (to 19 in.) TV (19in to 32”) TV (7 to 32”) TV stand  TV stand (large) vacuum cleaner wardrobe washer (clothes) Please list any items not in our list such as steel, lumber, tires etc.. Any special notes:

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