Hauler Sign Up Form

Please fill out the form below with as much detail as possible. If you have any questions regarding the form please email us at support@alliancedsp.com. We look forward to working with you and welcome you to the Alliance!

All required fields are marked with an *

Basic Info

Company Name

License Numbers

E.g. NJ haulers enter DEP & SW number. If none enter N/A

Billing Address & Info

We will be sending checks to this address

Address

Address 2

City

State

Zip Code

Notes About Billing

Hours of Operation

Contact Info

Primary Contact Name

Primary Contact Phone

Primary Contact Email

After Hours Contact Info

Contact if we need to reach you after your office closes

Same as primary

Scheduling Info

Email for confirmation emails

These emails must be replied to in a timely manner

Can you handle live loads?

Yes

Do you have a small truck for tight spaces?

Yes

Are you available for emergency after hours loads?

Yes

Rental Period Included with Rental

Rental Extension Policy

What sizes do you carry?

10 Yard

20 Yard

30 Yard

Add Size

Add one at a time

What materials do you service?

Household Items

Construction Debris

Concrete

Asphalt

Brush & Branch

Add Material

Add one at a time

Notes on sizes and materials

Pricing Info

Trip Charge

Notes on pricing & counties

If you do not service every town in a county, please let us know

State

County

Material	Haul Rate	Charge By	Dump Rate	Available Sizes
Household Items	$	By Ton	$	All
Construction Debris	$	By Ton	$	All
Concrete	$	By Ton	$	All
Asphalt	$	By Ton	$	All
Brush & Branch	$	By Ton	$	All

Submit

Additional notes

After submitting your application you will receive a confirmation email once it has been reviewed by an Alliance team member. We also require a certificate of insurance to be emailed to dispatch@alliancedsp.com before sending work your way.

By submitting this form and accepting work from Alliance Disposal you are agreeing to our partnership agreement.