182554 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
ONE CIVIC SQUARE STERICYCLE INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $110.28
i r PO BOX 9001588
LOUISVILLE KY 40290 -1588 CHECK NUMBER: 182554
CHECK DATE: 211712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4001444259 110.28 OTHER EXPENSES
Page: 1 of 2
INVOICE INVOICE DATE 02101/2010
Stericyde: INVOICE NUMBER 4041444259
o Protecting People. Reducing Risk: CUSTOMER, NUMBER 1016765
CARMEL WASTE WATER UTILITY
JOHN DUFFY For billing, scheduling or customer service:
760 3RD AVE SW (866) 783 -7422
CARMEL, IN 46432 -2584 Hours: (Mon Fri) 7:00 AM 7:00 PM CST
CustomerCare @Stericycie.com
YOUR ACCOUNT REFLECTS A BALANCE 30 DAYS PAST DUE
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $110.28
CURRENT ADJUSTMENTS $0.00
CURRENT INVOICE CHARGES -TAXABLE
CURRENT INVOICE CHARGES NON TAXABLE
Steri -Safe $110.28
TAX TOTAL $0.00
CURRENT INVOICE CHARGES SUB TOTAL $110.28
TOTAL ACCOUNT BALANCE DUE BY 03/0312010 $220.56
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 AZ, MO, NM, NY, PA, PR, and WI, this
invoice also serves as a certification of destruction.
Account History
Current 1 30 days 31 60 days 61 90 days 90+ days Total Account
Past Due Past Due Past Due Past Due Balance
$110.28 $110.28 $0.00 $0.00 $0.00 $220.56
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.
STERICYCLE, INC. (866) 783 -7422 Page: 2 of 2
CARMEL WASTE WATER UTILITY CUSTOMER 1016765 INVOICE M 4001444259 INVOICE DATE: 02/0172010
SERVICE SUMMARY
DATE MANIFEST /ORDER NUMBER TYPE
Site 001: Carmel Household Hazardous Wst, 801 N Range Line Rd, Carmel, IN 46032 -1361
02/0112010 Steri -Safe OSHA Economy WITH
VOUCHER 097297 WARRANT ALLOWED
"352121 IN SUM OF
STERICYCLE INC.
P.O. Box 9001588
Louisville, KY 40290 -1588
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
4001444259 01- 736H -08 $110.28
Voucher Total. $110.28
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
352121
STERICYCLE INC. Purchase Order No.
P.O. Box 9001588 Terms
Louisville, KY 40290 -1588 Due Date 2/912010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/2010 4001444259 $110.28
I 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
Date Officer