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This option reguires the Member Agency to include the cost of this Program in its <br /> garbage rates. <br /> 11. APPLICATION SUBMITTAL <br /> By submitting this application, the Agency agrees to pay its share of the Door-to-Door <br /> Household Hazardous Waste Collection Program costs, listed on line 9. <br /> The current contract term to provide the Program is through December 31, 2015 and can be <br /> extended at the discretion of the SBW for one additional year. The Agency must provide <br /> SBWMA sixty(60) days notice of its de 'sion to provide additional service to multi-family <br /> residences. <br /> The Agency also agrees to cooperate with SBWMA generally in administering the Prograrr�. <br /> Member Agency SBWIVIA <br /> � �� <br /> By: �� �� o� �?e��vJ C� 7`� By: " <br /> (Signature of auth rized representative] (Signa ure of authorized representative] <br /> Name:�� �1c,fG� Name: Kevin McCarthv <br /> Title: �SSis�h���'c � ��V�j►� Title: Executive Director <br /> Date: ( /�; /�(� Date: _ � I� �� <br /> � <br /> SBWMA Member Agency Application Form For <br /> Door-to-Door Household Hazardous Waste Collection Program <br /> Page 6 of 6 <br />