HomeMy WebLinkAbout(0057) FWS Application 2019.07.17.pdfFoRTWORTH® APPLICATION FOR
NON-EXCLUSIVE PRIVILEGE AGREEMENT
(Collection and Transportation of Municipal Solid Waste)
INSTRUCTIONS: Complete form and return to City of Fort Worth, Solid Waste Management Division
4100 Columbus Trail, Fort Worth, TX 76133
Trade Name of Applicant
FRONTIER WASTE SOLUTIONS
Physical Address
101 JENNINGS PKWY, HILLSBORO, 76645
Contact Name
TIM HENDERSON
Contact
940-453-8839
Mailing Address
PO BOX 1283
Telephone Number 888-854-2905
HILLSBORO, TEXAS 76645
Fax Number NIA
1. Briefly describe the nature and character of the service the applicant proposes to
render. TEMPORARY AND PERMANENT SOLID WASTE SERVICES
2. Estimated Number of Vehicles Operating Under this Agreement. A list
of all vehicles must be attached to this application. The list shall
include make, model, year and license plate number of all vehicles to 3
operate under this Agreement.
3. Do each of the vehicles listed in question 2 above have a current City
of Fort Worth Hauling Permit? I NO
4. Applicant has attached Certificated of Liability Insurance as required in Circle One
the Non -Exclusive Privilege Agreement, section 13. (OE P NO
5. Signature of pers horized by the Company to sign this Application
Signature
Title VICE PRESIDENT Date 7/17/2019
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Far City Use Only
Privilege Agreement Number: Date Approved:
Period Covered: to Approved M&C Number:
- r
Distribution: City Secretary, Solid Waste Division, Applicant