Client Billing Form - EcoSet Consulting

Which EcoSet service segment are you engaging?*

Zero Waste services (commercials, events)

Canned water purchase

ReDirect (materials diversion)

Scenic rentals (flats, jacks, sandbags)

Space rental (temporary maker space)

EcoSet On-Demand (transportation & logistics)

Purchase Order # for EcoSet services*

Required for Net 30 payment terms. Indicate if N/A.

Job name / Job #*

Client contact name*

Client contact email*

Client contact phone*

Billing company name*

Billing address*

Billing contact name*

Billing contact email*

Billing contact phone*

Water sales, scenic rentals and space rentals are due upon service unless other billing terms have been approved.

Preferred payment method*

ACH

Check

Wire Transfer

Credit Card (3% fee applies)

Other

Billing notes for EcoSet?

Card Type*

Carholder Name*

First Middle Last

Credit Card Number*

Expiration Date*

Day Not Required

Security Code*

Zip Code*

ZIP / Postal Code