COLLECTION REQUEST FORM
All the tables in this form must be filled in. It is vital that the correct information is given as this may result in
cancelled collections if not provided.
If you are unsure how to fill in any section of this form, please contact the RDC Money4Computers Administrator
on 01376 503600
Please send completed forms to: MONEY4COMPUTERS@RDC.CO.UK
YOUR CONTACT DETAILS:
Charity Name:
Contract Number:
RDC/2200
Collection Address:
Collection Post Code:
(Contact 1) Name:
(Contact 2) Name:
Telephone No.
Telephone No.
E-mail:
E-mail:
DETAILS OF ITEMS TO BE COLLECTED:
Please note that monitors, speakers and disk drives cannot be accepted.
Type of Equipment
Quantity
(minimum
collection of
15 items)
Equipment Details
(Please provide as much information as possible, e.g. laptops are in
bags, printers/ servers require two or more men to lift)
Laptops/Notebooks:
Desktop Systems/PCs
Accessories (Keyboards, Mice, Leads etc)
Please Note: The WEEE Regs 2006 require the reporting of all IT Waste & Transfer notes must record all waste transfers.
RDC hold the required permits to recover & recycle IT WEEE as a WEEE (AATF) & Waste Management Licensed site.
1.
2.
ARE THE ITEMS FOR REUSE? Were the items still in use and
functional until disconnected from the power supply/network & do
you think the equipment could be used as originally intended?
Note RDC assess items for safety, functionality, resale potential
& eradicate data before reuse by others.
ARE THE ITEMS WASTE? Would you classify the used
equipment as “waste” (e.g.. they are broken, dangerous or
require guaranteed destruction i.e. shredding / incineration for
security purposes?
RDC, 29 EASTWAYS, WITHAM, ESSEX, CM8 3YQ
Telephone: 01376 503600. Facsimile: 01376 504631
Web: www.rdc.co.uk
IMS
ISO 9001: 2008
ISO 14001: 2004
ISO 18001: 2007
ISO 27001: 2010
OHSAS
PAS 99:2006
Yes
No
Doc. Ref. Blank Collection Form Ver.1.9; Dated Apr ‘10
Author: Ben Giovine
Page 1 of3
COLLECTION REQUEST FORM
COLLECTION DETAILS:
A 09:00am to 17:00pm collection service is available. Free collection is only available in the England, Southern
Scotland and Eastern parts of Wales – see the “Green Zones” on the map available for download
If you require timed collections or collections outside of the collection zone, please phone your RDC administrator
for advice and possible arrangements.
Please note that if at the time of collection quantities and collection details vary from supplied information, RDC
reserve the right to collect at a later date and, make additional charges as appropriate (subject to contract
agreement). If the sizes of any large items are not stipulated this may also result in aborted collections due to
vehicle size and capacity.
1.
WHERE IS THE EQUIPMENT TO BE COLLECTED FROM?
(e.g. Loading Bay, comms room, 1st Floor).
2.
3.
4.
IS THERE A LIFT AVAILABLE FOR THE COLLECTION?
Yes/No (please delete)
(Please make sure that the equipment and courier can fit in the
lift, if not please put ‘No’).
ARE THERE ANY PARKING RESTRICTIONS? (e.g. double
yellow lines, London Red Routes, height restrictions, limited time
periods. Full details must be given – Lack of legal and ample
parking may result in RDC aborting the collection. If council
dispensation is required, contact your administrator at RDC for
further details).
ARE THERE ANY RESTRICTIONS ON THE ACCESS
ROADS? (e.g. weight restrictions, bridge height restrictions &
one way systems).
5.
ARE THERE ANY HEALTH AND SAFETY REGULATIONS
THE COURIER HAS TO ADHERE TO? (e.g. are the couriers
allowed to carry equipment up/down the stairs if a lift is
unavailable; are steel toe cap shoes, hard hats & high visibility
vests required).
6.
PLEASE STATE ANY DATES WHEN COLLECTION WILL
NOT BE POSSIBLE:
PLEASE STATE ANY OTHER INFORMATION YOU MAY WISH TO INCLUDE:
DETAILS FOR PAYMENT
Invoice Contact Name:
Invoice Contact Telephone number: (if
different from collection telephone number)
Invoice Address: (if different from collection
address)
Preferred Payment Method :
Cheque/BACS (please delete)
If BACS, please give
details:
Account Name
Account Number
Sort Code
Bank Name
CONFIRMATION OF DETAILS:
Confirmed by (Print Your
Name):
Date:
RDC, 29 EASTWAYS, WITHAM, ESSEX, CM8 3YQ
Telephone: 01376 503600. Facsimile: 01376 504631
Web: www.rdc.co.uk
IMS
ISO 9001: 2008
ISO 14001: 2004
ISO 18001: 2007
ISO 27001: 2010
OHSAS
PAS 99:2006
Doc. Ref. Blank Collection Form Ver.1.9; Dated Apr ‘10
Author: Ben Giovine
Page 2 of3
COLLECTION REQUEST FORM
TERMS AND CONDITIONS
By using the RDC Money4Computers Scheme, the charity willingly enter into legally binding contract, as defined by the
following Terms and Conditions. RDC reserves the right to withdraw the Scheme at any time.
RDC will only accept desktop and laptop computers under this service. Screens, monitors and printers are not acceptable
under the Scheme.
RDC will test and audit all equipment within 10 days of receipt of them at RDC’s premises
RDC will remove data from all equipment, either using government approved data wiping software, or through physical
destruction through shredding. By shipping any equipment to RDC, the charity agrees to indemnify RDC against all claims
arising from the loss of data associated with the equipment
By shipping equipment to RDC, you agree to RDC’s valuation of the donated product
RDC will provide a Pricing Report to the person detailed above which will clearly detail the value each item has achieved.
Product which fails our testing will have a zero value and will be 100% recycled in line with the WEEE directive.
RDC will proceed with payment to the charity within 14 days of a zero-rated invoice being received from the charity for the
amount detailed on the Pricing Report.
PLEASE SEND COMPLETED FORMS TO MONEY4COMPUTERS@RDC.CO.UK. YOU WILL RECEIVE A RESPONSE WITHIN
2 WORKING DAYS OF SUBMISSION.
RDC, 29 EASTWAYS, WITHAM, ESSEX, CM8 3YQ
Telephone: 01376 503600. Facsimile: 01376 504631
Web: www.rdc.co.uk
IMS
ISO 9001: 2008
ISO 14001: 2004
ISO 18001: 2007
ISO 27001: 2010
OHSAS
PAS 99:2006
Doc. Ref. Blank Collection Form Ver.1.9; Dated Apr ‘10
Author: Ben Giovine
Page 3 of3