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y INVOICE
8500 Georgetown Road
♦ =
Indianapolis,IN 46268
...:Phone: (317)871-4090
Fax:(317)871-4094
TOLL FREE 1.800-877.4955
INVOICE NO: 36N100-14
INVOICE DATE:1/19/2017
CLIENT:
PROJECT INFORTNIATION
PROJECT ID:
AIR.JOILNT DUFFY DESCRIPTION: ROLL OFF DISPOSAL
CITY OF CARNIEL UTILITIES LOCATION:
30 NVEST MAN STREET,STE 220
CARAIEL,IN 46032
CONTRACT NO S07574
CONTACT: BILL KELLAM PROJECT MGR:GREG SPEARS
WORK PERFORMED THRU: 12/28/2016
WASTE MANAGEMENT SERVICES
DESCRIPTION UNIT QUANTITY PRICE/UNIT TOTAL
DISPOSAL(LANDFILL ROLL OFF BOX) 5.62 $ 60.00 $ 337.20
TRANSPORTATION 1.00 $ 200.00 $ 200.00
TOTAL
INVOICE $ 537.20
TERMS: NET 30 DAYS
LATE PAYMENTS WILL BE CHARGED INTEREST AT 1.5%PER MONTH
REMIT PAYMENT TO: AMERICAN INDUSTRIAL SERVICES,8500 GEORGETOWN RD,INDIANAPOLIS,IN 46268-1647
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CGS SERVICES,INC
7yf 1 PO BOX 212 r
2920 E US HWY 52 fA11 N
W r)J�lt MORRISTOWN,IN 46161 �'tWing Addrmu .
szz
ewes ire pK
IB L SITE INFORMATION
Site Nvner arises.lee=Landf ll ORP No.; '7:1 vat. W, .J � Z /
�wdtaixed.c� � —
TICKET 278033
CGS Services, Inc. Driver:Brian Wright
INDOT Q992164 Source PLT#2329
�+ 2920 E US 52
services Morristown,IN 46161
Inc.
Time In: Nov 22 2016 8:57AM Carrier: CGS Location: Scales
Time Out: Dec 28 2016 9:44AM Truck: CGS155 Container: IN:20C144N OUT-20C120N
Customer: AMERICAN INDUSTRIAL SERVICES AIS
Loads Tons
Order P.0. Coun Product Description Tons CuYd (�yt Unit Price Amount
Todd Today
29407 1 5.62 CARMEL HHW Hamilton Liquid Waste-Other LATEX,WATER BASED 5.62 20.00 5.62 TON
PAI NT
CUPCL FEE 5.62 TON
CTY LANDFILL FEE$1.00 5.62 TON
STATE LANDFILL FEE$0.60 5.62 TON
F&E
TRUCKING 1.00 LOAD
Gross Tare Net
46100 34860 11240 Pounds As driver for this company,I affirm that no hazardous waste is contained in this load and 1
23.05 17.43 5.62 Tons assume all responsibility for weight compliance to local,state and federal regulations.
Weighmaster: c}� Driver: - N 1'j L
J