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Address 2
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{[PNAME]}
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Address 2
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Dumpster Location
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Please Attach Certificate of Insurance naming the Township of Maplewood as an additional insured in an amount not less than $300,000.00.
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I certify & acknowledge that it is particularly noted that said Dumpster must be used for the disposal of construction materials only and no garbage whatsoever may be disposed of in the Dumpster. The container must be lighted at night with appropriate warning signals and cordoned off during daylight hours. These items will be monitored by the Police Department.
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
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