Pick-up Request Form - PurchasingConnection.org

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Northeast Service Cooperative
“Recycle Program”
FLUORESCENT BULBS, BALLASTS, ELECTRONICS, ETC.
PRICE SCHEDULE/ORDER FORM
LAMP TYPE
PRICE EACH
QUANTITY
Fluorescent 4 ft. and under
.30
__________
Fluorescent 5 ft. and over
.43
__________
U shape and Circular
.38
__________
Compact Fluorescent
.30
__________
Thrift/Mate Type Lamps
.44
__________
Shielded Fluorescents
1.05
__________
H.I.D. (High Intensity Discharge)
1.24
__________
Incandescent
.26
__________
Charge for Taped Lamps
.20 each
__________
Charge for Broken Lamps
.94 Per Pound
__________
Non- PCB
.44 Per Pound
__________
PCB
.62 Per Pound
__________
Electronics (includes computer, monitors, etc)
.69 Per Pound
__________
Batteries
1.49 Per Pound
__________
Do you need boxes? ________
How Many?
__________
Do you need fiber drums traded out? ______
How Many?
__________
Ballasts:
***Minimum of 150 tubes required for on-site pick-up of bulbs.
**** There is a $20.95 pick-up charge due to the rising cost of fuel *******
Agency or School District: ______________________________________________________
Pick-Up Location/Address: ______________________________________________________
Contact Person: _______________________________________________________________
Phone:________________________ Purchase Order:________________________________
Secondary Contact:____________________________________________________________
RETURN TO: Northeast Service Cooperative, 5525 Emerald Avenue, Mt. Iron, MN 55768, Attn: Jeanette M.
or fax to 218-741-1719.
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