Austin City Connection logo; link back to Austin City Connection home page
 
Options

Directory | Departments | FAQ | Links | Site Map | Help | Contact Us


Dillo Dirt Vendor Application Form 2008
* indicates required fields.
 
Date: 02/09/2012
Vendor Name: *
Mailing Address: *
City: *
State: *
Zip Code: *
 
Physical Address
(if different from mailing address):
City:
State:
Zip Code:
Central Texas Region: *
Telephone: *
Email: *
What is your preferred
method of communication?:
Company Web Site:
Do you want to sell
Dillo Dirt to the public?:
If you respond yes, we will add you to the public list on our website.
 
Truck Information  
Vehicle: *
Make: *
Year: *
License Number: *
Hauling Capacity: * in cubic yards.
 
Vehicle Two (if applicable)
Make:
Year:
License Number:
Hauling Capacity:  in cubic yards.
 

I have received a "Dillo Dirt Compost Marketing Agreement" and will comply with all requirements stated therein.

 
Name: *
Title: *

By clicking the "Submit application" button below, I am agreeing to the terms of this Dillo Dirt Vendor Application. I will fax a copy of my proof of insurance for the above truck to Jody Slagle at (512) 972-1900.

     

Official Seal of the City of Austin
Austin City Connection - The Official Web site of the City of Austin
Contact Us: jody.slagle@ci.austin.tx.us or (512) 972-1950.
Legal Notices | Privacy Statement
© 2001 City of Austin, Texas. All Rights Reserved
P.O. Box 1088, Austin, TX. 78701 (512) 974-2000