The personal information on this form is being collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FIPPA) and will be used for the administration of the Town of Comox solid waste service. Should you have any questions regarding the collection or use of your personal information, please contact the Town of Comox at town@comox.ca or 250-339-2202.This service is for households that are unable to have their carts set out for collection in the way that is outlined in the Cart Set Out Guidelines .If a household meets the Service Conditions below, the waste contractor will collect their carts from an agreed upon location on their private property, take carts to the collection truck and return carts to their original location.SERVICE CONDITIONSThe Assisted Cart Set-Out Service is only for households that are unable to have their carts set out for collection due to all of the following being met:– There is no one in the household that is physically able to do this.– The household cannot find a neighbour or family member to do this.– The household is not financially able to hire a contractor to do this. Public Works must approve the cart location, which must be within a reasonable distance from the curb. The resident must comply with this agreed-upon cart location in order for the assisted cart collection to take place. Participants must notify the Town of Comox if they no longer need this service.If any of the service conditions no longer apply, this service may be terminated by the Town.This service is subject to an annual review.By submitting this application, I hereby certify that I have, and will, meet all of the Service Conditions outlined above, and I waive any claims against the Town and the Contractor for any property or other damage as a result of the Town or the Contractor providing the Assisted Set-Out Service, whether or not such damage was caused by the negligence of the Town or the Contractor. Civic Address Address Address 2 Do you live in a duplex or multi-unit building? Yes No Please provide your unit number (or other unit identifier): Contact Information Last Name First Name Email Phone For a designate who provides support to the resident (optional) Last Name First Name Email Phone How long do you need help for? Year-RoundI have a mobility challenge and need ongoing assistance. TemporaryI have a temporary mobility challenge and will only need help for a short period of time. Add Comments (optional)Include any additional details to consider with your application. CAPTCHA By submitting this application, I hereby certify that I have, and will, meet all of the Service Conditions outlined above, and I waive any claims against the Town and the Contractor for any property or other damage as a result of the Town or the Contractor providing the Assisted Set-Out Service, whether or not such damage was caused by the negligence of the Town or the Contractor.
