Gravity Forms Retailer Test

1

Type of Business/Organization*

2 Location Information

Name of Business/Organization Requesting Service*

Pickup Location Business Name

If different than organization requesting service.

Pickup Street Address*

Address Line 2

City*

County*

State*

Zip Code*

3 Contact Information

Primary Contact Name*

First Last

Primary Contact Title*

Primary Contact Email*

Primary Contact Office Phone*

Primary Contact Cell Phone*

Are you a parent organization with more than one program pickup address (e.g. a retail chain with multiple store locations)*

Parent Business/Organization Name*

Street Address*

City*

County*

State*

Zip Code*

Phone*

Are you a third party logistics provider servicing a retail location?*

Please list the retailer(s) you are servicing:*

4 Secondary Contact Information

Secondary Contact Name

First Last

Secondary Contact Title

Secondary Contact Email

Secondary Contact Office Phone

Secondary Contact Cell Phone

5 Site Logistics

Requesting entity must have the capacity to accommodate a 53-foot trailer. Can your site accommodate this?*

Provide a description of where the trailer must be dropped.*

Upload map of trailer location if available.

Max. file size: 256 MB.

Select the number of expected units per month (mattresses and box springs to be counted separately).*

Requested trailer delivery date*

Approximately how often will you need this service?*

Please note any site-specific restrictions, logistical concerns, or additional pertinent information.

6

Terms and Conditions*

I have read and agree with the terms and conditions to the Commercial Volume Pickup service requirements.

Terms & Conditions:

The Mattress Recycling Council California, LLC (“MRC”) is the non-profit mattress recycling organization certified by the State of California to plan, implement, and administer the California Mattress Recycling Program (the “Program”) established pursuant to the Used Mattress Recovery and Recycling Act (the “Act”) (California Public Resources Code § 42985, et seq.). MRC welcomes your participation in the Program.

By completing this registration, you, the “Participant”*, are bound to the following terms and conditions:

1. MRC’s Commercial Volume Program (“CVP”) is a commercial volume pickup service that is open to mattress retailers, lodging establishments, healthcare facilities, educational institutions, and military bases with more than 100 units to pick up at one time. Each mattress or box spring constitutes a single unit. All discarded mattresses and box-spring units must have been used and discarded in California in order to qualify for CVP (collectively referred to as “Program Materials”). Mattress retailers must be registered as a retailer with MRC, remit any and all applicable mattress recycling fees, and remain in compliance with the Act in order to participate in CVP.

2. An MRC-designated transporter (“Transporter”) will provide an MRC-approved container (“Collection Container”) for Participant to store Program Material at the Participant’s facility, as well as pick up the full Collection Container from Participant’s facility and deliver it to an MRC-contracted mattress recycling facility (“Recycler”) to recycle acceptable Program Materials. The Collection Container, transportation of the Collection Container and recycling of acceptable Program Material is provided at no cost to the Participant.

3. Participant will cooperate with the Transporter to schedule convenient pickup times and to facilitate efficient loading of Program Materials in Collection Container(s).

4. Participant must provide at least two staff members to load Program Materials onto the Collection Container(s).

5. Participant must abide by the California Collection Guidelines ("Guidelines"), which can be found at https://bit.ly/3sJaHyu which outline MRC’s expectations. These include but are not limited to Participant’s obligations to:

a. Train staff to identify which Program Materials are acceptable and which are prohibited.
b. Prevent material discarded from residents and businesses outside the state of California from entering as Program Materials.
c. Keep collected Program Materials dry and intact to maximize what can be recycled.
d. Efficiently stack Program Materials in Collection Containers to maximize capacity.
e. Remove any furniture, tires, mattress or futon frames, electronics, loose bedding, mattress toppers, or garbage and other materials defined in the Guidelines as unacceptable (collectively referred to as “Non-Program Materials”) from Collection Containers.
f. Notify Transporter at least two days before your Collection Container is full.
g. Complete all MRC-required paperwork and reporting requirements as outlined in the Guidelines.

6. MRC cannot accept any Program Materials that are severely damaged or soiled, twisted, wet, frozen, infested with bed bugs or are otherwise unsuitable for recycling. Program Materials in these conditions must be disposed of as solid waste at Participant’s expense.

7. Participant will inspect Collection Container(s) upon arrival and determine whether they are in proper condition for use. MRC or its Transporter is responsible for replacing any defective Collection Containers and repairing normal wear-and-tear to the Collection Containers. Participant will immediately notify MRC if at any point a Collection Container(s) is destroyed, damaged or not in proper condition for use and will not use any such defective Collection Containers until they are repaired or replaced by MRC or its Transporter. Participant will exercise reasonable care in securing and maintaining their premises and safeguarding Collection Container from damage.

8. Participant must maintain commercial general liability insurance with policy limits of at least $1,000,000 per occurrence and upon request, will provide MRC with proof of coverage. Participant must cooperate with MRC, its Transporter and any and all commercial insurers, in the event of a claim of damage to a Collection Container.

9. MRC requires its Transporters to maintain automobile liability insurance coverage with policy limits of at least $1,000,000 per occurrence.

10. MRC is not liable for any damage to persons or property, including Collection Containers, resulting from the use, misuse, or failure of any property used by the Participant or any of its employees or contractors, even if such property is furnished, rented, or loaned to Participant by MRC or its Transporter.

11. IN NO EVENT WILL MRC BE LIABLE FOR SPECIAL, INDIRECT, CONSEQUENTIAL, OR INCIDENTAL DAMAGES, OR LOST PROFITS, LOSS OF REVENUE, OR LOSS OF USE ARISING OUT OF OR RELATED TO THESE TERMS & CONDITIONS, WHETHER SUCH DAMAGES ARISE IN CONTRACT, NEGLIGENCE, TORT, UNDER STATUTE, IN EQUITY, AT LAW OR OTHERWISE.

12. Participant will have control of all operations and will make their own decisions regarding the manner in which their operations are performed. Nothing in these terms and conditions will be construed to designate Participant, or any of its employees or subcontractors, as employees, agents, joint ventures, or partners of MRC.

13. MRC may terminate Participant’s participation in the Program immediately if Participant does not meet these terms and conditions.

14. Participation in the Program is voluntary. Participant may terminate their participation in the Program upon ten days written notice to MRC.

15. Upon termination of CVP participation, Participant agrees to immediately cease using all MRC, CVP and Bye Bye Mattress marketing material, badges and logos including but not limiting to removing any and all online and printed references to Participant’s CVP registration and involvement.

Participant agrees to these terms and conditions. 

Collection Guidelines*

I have read and agree to the Commercial Volume Program Collection Guidelines on behalf of the Collection Site. Commercial Volume Program Collection Guidelines

In State Units Only*

I confirm I am not using the program to recycle mattresses and box springs discarded from any person or location outside the State of California.

Commercial General Liability Insurance*

Participant confirms commercial general liability insurance of $1,000,000 per occurrence is maintained and proof of coverage is available to MRC upon request.

7

Signature*

Print Name*

Signature Date*

ATTENTION

THANK YOU FOR YOUR INTEREST

ATTENTION

Things to keep in mind...

CA CVP Mattress Retailer

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2

Location Information

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Contact Information

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Secondary Contact Information

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Site Logistics

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