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| PROUD SPONSOR OF HOUSEHOLD GOODS RECYCLING OF MASSACHUSETTS |
"FREE UP SPACE IT WILL MAKE YOU FEEL GOOD" FEEL GOOD KNOWING SOME OF YOUR UNWANTED STUFF GOES TO HELP OTHERS |
PROUD SPONSOR OF THE MASS COALITION FOR THE HOMELESS |
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Clean Out Your House Inc. 2352 Main Street Unit 9C1 Concord, MA 01742 Tel:(781)-826-3120 |
The Jon Doe Residence 53 Chesnut st Newton,MA 02165 Tel:(555)555-5555 |
| DATE |
SIGNATURES |
DATE |
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REMOVAL OF MATERIAL AND HOUSEHOLD GOODS FOR DISPOSAL AND DONATIONS |
| LABOR FOR REMOVAL | # OF HOURS | -- | LABOR RATE | LABOR CHARGE |
| -- | -- | -- | PER HOUR | EXTENDED |
| LABOR | 4 | (2 MEN, 4 HOURS WITH A TRUCK) | $110.00 | $440.00 |
| -- | Labor Time Includes Travel, On Site Unloading, and Charity Where Applicable | -- | -- | |
| -- | -- | -- | -- | -- |
| TOTAL LABOR CHARGE | 4 | -- | $110.00 | $440.00 |
| -- | -- | -- | -- | -- |
| OTHER COSTS | COST | DESCRIPTION / NOTES | QUANTITY | COST |
| TV'S AND COMPUTERS | $10.00 | TUBE IS HAZARDOUS GOES TO STATE FACILITY | 1 | $10.00 |
| HAZARDOUS WASTE | $9.00/GALLON | GOES TO CLEAN HARBORS FOR DISPOSAL | 10 | $90.00 |
| RUBBISH DISPOSAL | .15 CENTS/LB | DUMPSTER AT CLEAN OUT YOUR HOUSE | 1000 | $150.00 |
| DISPOSAL OF APPLIANCES | $25 EACH | WE TAKE IT AWAY AND DISPOSE OF IT | 1 | $25.00 |
| -- | -- | -- | -- | -- |
| TOTAL DISPOSAL CHARGES | -- | -- | -- | $275.00 |
| -- | -- | -- | -- | -- |
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TOTAL ESTIMATE FOR REMOVAL |
-- | -- | -- | $715.00 |
| -- | -- | -- | -- | -- |
| -- | -- | -- | -- | -- |
| ITEMS DONATED | -- | DONATION INFORMATION | -- | RECEIPTS FOR TAX PURPOSES |
| -- | -- | -- | -- | -- |
| CLOTHES | -- | NEW | -- | $225.00 |
| -- | -- | USED
AND CLEAN COATS, JACKETS,SHIRTS,PANTS |
-- | $200.00 |
| -- | -- | USED AND DIRTY | -- | $175.00 |
| BOOKS | -- | NEW AND USED APPROX 100 | -- | $250.00 |
| APPLIANCES | -- | STOVE, REFRIG,A/C UNIT | -- | $100.00 |
| FURNITURE | -- | 2 TABLES,4 CHAIRS,3 PICTURES | -- | $125.00 |
| RUGS | -- | 1 RUG | -- | $100.00 |
| SOFT GOODS | -- | SHEETS,BLANKETS,PILLOWS,CURTAINS | -- | $200.00 |
| GAMES/DOLLS TOYS | -- | 1 LOT OF NEW AND USED TOYS | -- | $150.00 |
| -- | -- | -- | -- | -- |
| TOTAL DONATIONS TO CHARITY | -- | RECEIPTS WIL BE SENT TO YOU WITHIN 30 DAYS FROM DATE OF REMOVAL | -- | $1,525.00 |
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CLEAN
OUT YOUR HOUSE INC. 2352 MAIN STREET UNIT 9C1 CONCORD, MA 01742 TEL: (781)826-3120 EMAIL:larry@cleanoutyourhouse.com |
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©2002 Clean Out Your House Inc. All rights reserved. 
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