Spotlex World Environmental Solution
Services Subscription Form Suite 11, Choice Plaza, Plot 51494 Rayfield Zaramanganda, Jos. 08037002250,
Subscription Payment Date
Please give a clear description of the operation point with the nearest landmark.
Client Phone Number
Tick the services you wish to subscribe to
Cleaning Services (Office/Home/Industrial
Street Cleaning/Refuse Dumping
Septic System Management
Fumigation Pest & Rodent Control
Waste Analysis/Waste Sorting
Drainage Dredging & Construction
Refuse Dump Clearing
Land Fill Setup/ Management
Supply of Bins/Refuse Sack
Supply of Sanitory/Environment Equipment
Fabric Management (laundry/dry-cleaning)
Environmental Training, Seminars & Consultancy Service
Environmental Legal Services
Mobile Toilet Supply
Environmental Impact Assessment
Environmental Audit Report
Environmental Management Plan
Extended Producers Resonsibility
Household Waste (excluding Flowers, Grasses, Branches of Trees, Sand and Stones)
Garden Waste (Flowers, Grasses, Branches of Trees etc)
Demolition & Wreckages
Frequency per week
Once per week
Twice per week
Three time per week
Four time per week
Five time per week
Six time per week
Seven time per week
Service Agreement for Waste Collection Client only
My registration is personal and exclusive, I can not sublet or cohort others.
I Know I shall make my payment upfront, However, I shall invoke the Spotlex World MONEY-BACK GUARANTEE if I am Justifiably unsatisfied.
I may be billed for services in excess of the agreed volume if need be.
I shall package my waste decently in bags.
If I add any undisclosed services or category, It shall be negotiated.
Spotlex World shall not be held accountable for my failures to keep my waste as agreed.
Spotlex World may have reason to change collection days but shall duly inform me of the change
If you agree to the above statements, pls tick.
If your payment expires, would you want Spotlex World to automatically stop the collection of your waste until you pay for renewal?
Note that payment in arrears attract 20% interest per month, However, it is subject to our credit policy. Be that as it may, all debt must be cleared before you can terminate the contract.
yes, I authorize you to continue.
No, you should stop working until I renew.
Mode of Payment
Bank Deposit (Spotlex World 0030039475 of Diamond Bank)
Electronic Transfer (Spotlex World 0030039475 of Diamond Bank)
Cheque (in Favour of Spotlex World)
Yet to Pay
How did you hear about us?
Mr. Femi Kinrin
Ms Juliet Kinrin
Ajasi Danjos Joseph
Through one of your Client
A copy of your responses will be emailed to the address you provided.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service