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„ Sales Representatwe <br /> is Agreement <br /> ___ i <br /> E <br /> Account I Site Number <br /> Document Shredding » <br /> Service Frequency Additional Pick Up Description <br /> N/A N/A <br /> Waste Container+iz i Additional Pick Up Fee <br /> i <br /> Price <br /> N/A/Container//Pick Up Additional Container Charge <br /> OSHA Compliance <br /> Number of Employees Mock Compliance Walkthrough <br /> ®1-10 11-50 ®51-100 0100+ 13 Yes 9No <br /> Type of Office <br /> Medical ❑Dental Other <br /> Charge 1 Location Scheduling of training and walk-through are the responsibility of the customer,one per year <br /> N/A unless otherwise specified <br /> Waste Planning <br /> Solid Waste Consulting Additional Notes <br /> Medical Waste Management Plan Formation <br /> #of Locations Estimated Hours Needed For Planning Total Charge <br /> ❑Submissions to Regulatory Agencies <br /> Hazardous Waste <br /> Service Frequency <br /> N/A N/A <br /> Pick Up Fee <br /> Price I Container Size <br /> By signing this Agreement I understand and agree that I have read and understood the foregoing,the Terms and Conditions attached hereto,and all other provisions set <br /> forth in or attached to this Agreement. Further,by signing below I acknowledge and represent that I am an authorized officer or agent of the Customer and have authority <br /> to bind the Customer to this Agreement. _ <br /> Contract Effective Date Customer Initials <br /> Customer Date Name(print) Title <br /> lMichael Miller CFO <br /> Prima Waste anage ent Agent D e Name(print) Title <br /> Fernando Vasquez President <br /> THIS AGREEMENT IS SUBJECT AND SUBORDINATE TO THE TERMS AND CONDITIONS <br /> OF THE ADDENDUM ATTACHED HERETO AND INCORPORATED HEREIN. <br /> INITIAL. DATE <br /> 12401 Woodruff Ave.,Suite 10,Downey,CA 90241 -Phone(562)246-1250 <br />