Page 1 of 6 Municipal Recycling Bridge Funding Registration Form for New Applicants Eligibility Requirements Municipalities must: have operated paper and cardboard recycling programs since 2012; plan to continue the recycling operations in 2013-2014; and be able to provide records of recycling, including written receipts for the volume of paper and cardboard recycled in 2012. Submitting Your Registration Form Submission deadline is August 14, 2013. You can submit your form by mail, fax or email. We will confirm your acceptance into the program by email or telephone. Che Wei Chung Saskatchewan Urban Municipalities Association 200 - 2222 13th Avenue Regina, SK S4P 3M7 recycle@suma.org Phone: 306-525-4389 Fax: 306-525-4373 For additional information on the Municipal Recycling Bridge Financing Program, please visit www.saskmunicipalrecycling.ca Municipal Contact Information Please print clearly. Municipality Name:_____________________________________________________________ Recycling Contact:________________________ Street Address/Box #:__________________________________________________________ City/Town:____________________________________________________________________ Postal Code:_____________________________ Telephone:______________________________ Email: __________________________________ Mayor/Reeve: __________________________ Administrator: __________________________ Page 2 of 6 Eligibility Only municipalities that offer paper/cardboard recycling service to local residents will be considered for funding. To determine eligibility, please answer the following question: How are paper/cardboard services provided in your municipality? (Please check one) (a) Independent municipal operations (i.e., municipality sells material directly to a broker or paper mill) (b) Contract with waste management company (Loraas, Regens, Waste Management) (c) In partnership with a neighbouring municipality (not as part of a regional waste authority) (d) Through membership in a regional waste authority (e) Through a local SARC operation (f) Our municipality does not provide paper/cardboard recycling If you answered (d) or (e), bridge funding for your recycling service providers will be administered by SARC or ARWMAS. Please contact these organizations for further details. If you answered (f), you are not eligible for bridge funding. If you answered (a), (b) or (c) you are eligible for bridge funding. Please answer the following questions: YES NO Our municipality has operated a paper and cardboard recycling program since 2012. We plan to continue the recycling operations in 2013-2014; and We will provide records of recycling, including written receipts for the volume of paper and cardboard recycled from 2012. In order to receive bridge funding, eligible municipalities must complete the following questionnaire. Page 3 of 6 I. Contract Terms If your municipality has contracted a waste management company to provide paper/cardboard recycling services, please answer these questions. If not, skip to section II. 1. Please provide the terms of your contract arrangement (check one) (a) (b) (c) Full-cycle service (Company provides bins, collection, transportation. Municipality receives no revenue from paper mill or recycling broker.) Curbside collection: Yes No Partial-cycle service (Company provides bins, collection and transport to paper mill or recycling broker. Municipality receives revenue from/pays to paper mill or recycling broker.) Neighbour municipality (Municipality pays another municipality to pick up and transport locally-collected paper/cardboard.) 2. How is your municipality charged for paper/cardboard recycling service? Please fill in all applicable lines. Type of Charge Per capita Per tonne Per truck load Per bin tip Bin rental Flat rate Transportation surcharge Other: Current Rate ________________/capita ________________/tonne _________________/load ________________/bin tip ___________________/bin per month OR per year (circle one) ____________/month OR year _______/trip OR month OR year Rate Type (check one) Fixed Fluctuating Fixed Fluctuating Fixed Fluctuating Fixed Fluctuating Fixed Fluctuating Fixed Fixed Fluctuating Fluctuating Fixed Fluctuating II. Paper/cardboard recycling costs 1. What was the approximate cost for your municipality in 2012 for paper/cardboard recycling? a) total ________________________________ b) expenditures _________________________ c) revenues ____________________________ d) contract costs (if applicable)______________ 2. How does your municipality charge residents for recycling programming? a) ___ Included in tax base. Mill rate allocated to recycling paper/cardboard: ______ b) ___ Separate user fee. Amount and frequency of payment (per month, per year): __________ c) ___ Pay-as-you-throw. (Residents charged per bag or truck load) Amount: _________ Page 4 of 6 d) ___ No fee e) ___ Other (please describe) ______________________________________ III. Collection 1. How many collection points do you have in your municipality? _________________________ 2. What type of recycling equipment does your municipality own? (Please check all that apply) a) ___ Bailer b) ___ Haul truck c) ___ Bins How many? _____________ d) ___ Storage facility e) ___ Other (please describe) _______________________________________________ 3. For municipalities not contracted with a waste management company: Does your municipality offer curbside pickup for recycling? Yes _____ No _____ 4. Are there central collect bins in your municipality? Yes _____ No _____ How many bins? ______________________ Who provides the bins? _____________________ 5. Who empties full bins? (Please check one) a) ___ My municipality b) ___ Another municipality c) ___ Waste management company d) ___ Other (please describe) ______________________________________________ 6. How often are bins emptied? ________________________________ IV. Storage and Transport 1. Does your municipality have a place to store collected paper/cardboard? Yes _____ No _____ Where do you store it? (horse trailer, storage facility, etc) _____________________ 2. Does your municipality have a recycling facility (excluding SARC operations)? Yes ____ No ____ What are your hours of operation? __________________________________ How many people are employed at the facility? ________________________ If you serve any other municipalities, please list here or attach separate page: ___________________________________________________________________ Page 5 of 6 3. Who transports the recycling from the bin to its next destination*? (Please check one) * Destinations include a broker, mill, or other municipal facility. a) ___ My municipality b) ___ Another municipality c) ___ Hauler (Loraas, Waste Management, Regens, etc) d) ___ Other____________________________________ 4. Where is your recyclable paper/cardboard taken? a) ___ Recycling broker (Crown Shred, etc.) b) ___ Paper mill (mills outside Saskatchewan) c) ___ Other ___________________________________ d) ___ Don’t know 5. If your municipality receives revenue from recyclable paper/cardboard: a) How do you pay/receive payment? Per truckload _____ Per tonne _____ b) How much do you currently pay/receive? Per truckload _____ Per tonne _____ Page 6 of 6 V. Types of materials Material How much is collected annually? Who collects it? Antifreeze Appliances Batteries Cardboard Computers/electronics Glass Household hazardous waste Milk jugs/cartons Organics/compost/yard waste Paint/paint products Paper (mixed, newsprint, magazine) Plastic (household) Prescription drugs Scrap metal Tin cans Tires Wood/trees Other (please describe) Please Remember: Along with your application form, you must include receipts for the volume of paper and cardboard recycled in 2012. Submission deadline is August 14, 2013.