Wood Chip Request Form

Boutte Tree Inc.
2144 Bolton Rd. NW
Atlanta GA 30318
Office (404) 799 5472 Fax (404) 799 8661 Emergency (404) 234 0837 tierson@bouttetree.com www.bouttetree.com
FREE WOOD CHIPS FORM
Please fill out this form and fax it to Boutte Tree Inc. at 404 799 8661, or email to
Tierson@bouttetree.com, to have free wood chips delivered to your house.
Name: [Enter Your Name Here]
Address: [Enter Your Street Address Here]
City: [Enter Your City Here]
Zip: [Enter Your Zip Code Here]
Phone Number 1:[000-000-0000]
Phone Number 2:[000-000-0000]
# Truckloads of Chips desired [# of Truckloads] (You may call to cancel any undelivered loads)
Note that each truckload varies between 10 and 25 cubic yards of mulch
A healthy adult, using a wheelbarrow, can move 3 yards of chips 50' on level ground in about an hour
Please initial each of these stipulations on chip delivery to indicate agreement:
XX I am the property owner or manager of the above address
XX I will hold Boutte Tree harmless for any driveway cracks or underground utility damage resulting from the use of their trucks in delivering the
chips
XX I understand that the quantity of mulch per truckload delivered is variable and there may be less or more chips than I need for my project. I
will not complain about the size of delivered pile of mulch unless more than the specified number of truckloads of mulch was delivered.
XX I will hold Boutte Tree harmless for any turf damage sustained while trying to drive on unpaved surfaces.
XX I will accept delivery of the chips on any part of my property if my preferred dump location is unreachable.
XX I understand that the quality of chips is variable, and will not complain about the size or consistency of the chips. The load will be free of
logs or other trash.
XX I understand that occasionally poisonous plants are included in the wood chips and agree to hold Boutte Tree harmless for any discomfort,
llness or malady resulting from the presence of any poisonous plants inthe wood chips, such as poison oak and ivy.
XX I expect a call before the chips are delivered but I authorize delivery of the chips within the specified time period, noted below, even if I don't
answer the phone.
I will accept the chips within the following dates: XX/XX/20XX to XX/XX/20XX
Sketch of desired chip dump location: