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247490 07/15/15 CITY OF CARMEL, INDIANA VENDOR: 003521 21 a; ® r ONE CIVIC SQUARE STERICYCLE INC CHECK AMOUNT: $ """*"'41.81' CARMEL, INDIANA 46032 PO BOX 6575 CHECK NUMBER: 247490 CAROL STREAM IL 60197-6575 CHECK DATE: 07/15/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1094 4350900 4005667674 41.81 OTHER CONT SERVICES STERICYCLE,INC. (866)783-7422 PAGE:2 of 2 CARMEL CLAY P4kS AND RE�6 CUSTOMER#: 2245380 INVOICE#: 4005667674 INVOICE DATE: 06/30/2015 DATE MANIFEST/ QUANTITY/ DESCRIPTION WEIGHT PRICE TOTAL ORDER NUMBER CONTAINERS Site 001: Carmel Clay Parks and Recr, 1235 Central Park Dr E,Carmel,IN 46032-4421 06/19/2015 MDIDOOC43W 1.00 17x2Ox22 Large Box Disposal 0.00 Ib $35.831 EA $35.83 06/19/2015 MDIDDOC43W 1.00 Energy Charge 0.00 Ib $5.980 EA $5.98 Site 001:SUB TOTAL $41.81 Site 001:TAX TOTAL $0.00 Site 001: TOTAL $41.81 0 S 2015 JUL7TOTAL CURRENT INVOICE CHARGES $41.81 .BY: PAGE: 1 of 2 o 00 INVOICE INVOICE DATE : t ,:w 06/30/2015 ©O O Ster0C�yde* INVOICE NUMBEW� ? ++- 400566767,4 O O Protecting People.Reducing Risk: CUSTOMER NUMBER ''2245380 Site&Purchase Order Info.omReverse Page CARMEL CLAY PARKS AND RECR ���.•JJ�� For billing,scheduling or customer service: ACCOUNTS PAYABLE (866)(866)783-7422 JUL 1411 E 116TH ST Hours:(Mon-Fri)8:00 AM-5:00 PM CARMEL IN 46032-3455 CustomerCare@Stericycle.com BY: ACCOUNT SUMMARY DESCRIPTION DATE AMOUNT TOTAL PREVIOUS BALANCE $41.81 CURRENT ADJUSTMENTS ($41.81) Thank You-Payment#246544 06/22/2015 ($41.81) CURRENT INVOICE CHARGES (See Reverse Page For Details) $41.81 TOTAL ACCOUNT BALANCE DUE BY 07/30/2015 $41.81 CERTIFICATION:The material listed on the manifest(s)(infectious medical waste)has been treated in accordance with the requirements of federal,state and local regulations governing the treatment of such waste.A copy of this certificate,applicable manifests,and the appropriate logs will remain on file with the company.For customers in WI,this invoice also serves as a certificate of destruction. Account History Please disregard if payment has been sent. Current 1-30 days 31-60 days 61-90 days 90+days Total Account Past Due Past Due Past Due Past Due Balance $41.81 $0.00 $0.00 $0.00 $0.00 $41.81 PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT IN THE ENCLOSED ENVELOPE.TO ENSURE TIMELY POSTING OF YOUR PAYMENT,PLEASE ALLOW 5 DAYS FOR MAILING. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 00352121 Stericycle, Inc. Terms P.O. Box 6575 Carol Stream, I L 60197-6575 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 6/30/15 4005667674 Regulated medical waste 6/19/15 $ 41.81 Total $ 41.81 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer Voucher No. Warrant No. 00352121 Stericycle, Inc. Allowed 20 P.O. Box 6575 Carol Stream, IL 60197-6575 In Sum of$ $ 41.81 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1094 4005667674 4350900 $ 41.81 1 hereby certify that the attached invoice(s), or bill(s) is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except July 9, 2015 PAN"VA" Signature $ 41.81 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund