314387 07/31/17 CITY OF CARMEL, INDIANA VENDOR: 366244
ONE CIVIC SQUARE MEDASSURE CHECK AMOUNT: $*******540.00*
s ?Q; CARMEL, INDIANA 46032 920 E COUNTY LINE ROAD CHECK NUMBER: 314387
SUITE 102 CHECK DATE: 07/31/17
LAKEWOOD NJ 08701
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 W46000 540.00 OTHER EXPENSES
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Invoice
MedAssure Date Invoice No.
920 E County Line Rd
��^ Suite 102 06/08/2017 W 46000
ASSURE Lakewood,NJ 08701 Terms Due Date
(732)363-7444
billing@medassureservices.com Net 30 07/08/2017
Bill To:Customer ID:(4393-8324) Ship To:
Carmel Household Hazardous Waste Carmel Household Hazardous Waste
30 West Main 901 N Range Line Rd
Carmel,IN 46032 Carmel,IN 46032
Tracking#:8324-06-08-2017-413612-B
SIC# Tax Exempt ID# Balance Due Enclosed
$540.00
PO Number# Ship Date Ship Via
06/08/2017 MedAssure
Date Description Cont.Count Weight Unit Price Amount
06/08/2017 Manifest# 8324-06-08-2017-413612-B
31 Gallon Tub(RMW) 10 346 $30.00 $300.00
Flat rate for first 8 RMW cont(s). $240.00 $240.00