Supply Request

Supply Request Form
(Have you submitted the required Cleanup/Beautification Form yet?)

Must have SITE BOX SCORE FORM when returning equipment

* Indicates required field

Contact Person *

First

Last

Organization *

Pick-up date *

Mobile Number *

Cleanup date *

Email *

Supplies Assigned and Returned
(please indicate numerical amount of items requesting)

Trash Bags *

Vests *

Gloves *

Orange Cones *

Litter Grabbers *

Hand Claw *

Garden Rake *

Heavy Metal Rake *

Push Brooms *

Small Hand Trowel *

Wheelbarrow *

Debris Shovel *

Long Nose Shovel *

Regular Shovel *

Square Head Shovel *

Long Scrappers *

Machete *

Swing Blade *

Hand Saw *

Pitch Fork *

24' Big Wheel Mower *

21' Small Mower *

Weedeater *

Weedeater Trim Cord *

Weedeater Oil/Gas Mix *

Goggles *

Gas Can - citizen fill up *

Square Head Hoe *

Loppers *

Hedge Trimmer *

5 Gallon Cooler *

10 Gallon Cooler *

Ice Chest *

Post Hole Digger *

Spading Fork *

Tables (3) *

Ladders (2) *

First Aid Kit *

Coca Cola Recycling Bin *

Other/Comments *

Keep Houston Beautiful @ Environmental Service Center, 5614 Neches, 713-805-4953 or KHB office: 713-839-8855; Fax: 713-839-8880

Note: A $50.00 deposit or $100.00 deposit (for power equipment) is required EXCEPT when only trash bags are requested! All above items must be returned, including gloves and vests, in order for the deposit to be returned. Damaged or missing tools will be deducted from the deposit. An invoice for the difference will be issued to you.

By checking the box below you agree:
-     To use tools for a community beautification project, cleanup, improvement and/or maintenance project
-     To pick up and return tools to the KHB warehouse in a timely manner
-     To store the tools in a secure location, protected from the weather
-     To be financially responsible for any missing or damaged tools (other than normal wear and tear)

Check the box below to accept these terms. *

I agree.

Submit

Supply Request Form(Have you submitted the required Cleanup/Beautification Form yet?)

Supplies Assigned and Returned(please indicate numerical amount of items requesting)

Supply Request Form
(Have you submitted the required Cleanup/Beautification Form yet?)

Supplies Assigned and Returned
(please indicate numerical amount of items requesting)