Required fields are marked with asterisks (*)

City of Belleville

Bulky & White Goods Curbside Pickup Form

Name:

Email Address:

Phone Number:

Address (Street number and Name):

City

Postal Code

Is the pickup address same as above? (If yes, go straight to payment)

Yes

Pick up address if different from address above

Enter your City here (pick up address)

Enter your postal code here (pick up address)

Small Furniture Items - $20.00 (Example: Kitchen Chair, End Table, Bundled Wood, Etc.)

Large Furniture Items - $25.00 (Example: Couch, Chair, Mattress, Box Spring, Toilet, Etc.)

Non-Freon White Good Items - $40.00 (Example: Stove, Dishwasher, BBQ, Dryer, Etc.)

Freon White Good Items - $50.00 (Example: Fridge, Freezer, Air Conditioner, Water Cooler, Etc.)

NOTE:

Bulky Items are picked up on Friday's only.

Effective September 1, 2020 the deadline for Bulky Item pickup is being changed to 3:00 p.m.on Wednesdays (two days before) your preferred pickup date in order to be on the list.

White Goods are picked up Monday through Friday. Please select your preferred pickup date below for a White Goods pickup only.

Preferred date of White Good pickup only (Monday - Friday)

Please enter quantity of Freon Items (White Goods) - $50.00 per item (Fridge, Freezer, Air Conditioner, Dehumidifer, Water Coolers)

Please enter quantity of Non-Freon Items (White Goods) - $40.00 per item (Stove, Dishwasher, Washer, Dryer, Microwave, Humidifier, Barbeque, Bath Tub, Shower Stall

Please enter quantity of Large Furniture - $25.00 per item (Couch, Chair, Desk, Mattress, Box spring, Toilets and Toilet Tanks)

Please enter quantity of Small Furniture - $20.00 per item (End Table, TV Stand, Kitchen Chair, Bundled wood, Bundled carpet)

Total for this Order

Personal Information is collected on this form for the purpose of licensing. Personal information is protected under the Freedom of Information Protection of Privacy Act. Question related to the colection of personal information should be referred to the Deputy Clerk for the City of Belleville.

If you have any problems with this e-form and need to speak to an attendant please contact the City of Belleville at 613-968-6481.

Upon completion and successful payment you will be e-mailed a receipt.

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City of Belleville

Bulky & White Goods Curbside Pickup Form

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