192256 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
0 f ONE CIVIC SQUARE STERICYCLE INC
s o CHECK AMOUNT: $130.13
CARMEL, INDIANA 46032 PO BOX 9001588
t r LOUISVILLE KY 40290 -1588
�o CHECK NUMBER: 192256
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4002108657 130.13 OTHER EXPENSES
Page: 1 of 2
p
INVOICE INVOICE DATE 11/01/2010
1 0000 Stericycle" INVOICE NUMBER 4002108657
eProtecting 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 46032 -2584 Hours: (Mon Fri) 7:00 AM 7:00 PM CST
CustomerCare @Stericycie.com
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $130.13
CURRENT ADJUSTMENTS ($130.13)
Payment -Ref #1190970 10/22/2010 ($130.13)
CURRENT INVOICE CHARGES TAXABLE
CURRENT INVOICE CHARGES NON TAXABLE
Steri -Safe $130.13
TAX TOTAL $0.00
CURRENT INVOICE CHARGES SUB TOTAL $130.13
TOTAL ACCOUNT BALANCE DUE BY 12/01/2010 $130.13
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
$130.13 $0.00 $0.00 $0.00 $0.00 $130.13
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 9016765 INVOICE 4002108657 INVOICE DATE: 11/01/2010
SERVICE SUMMARY
DATE MANIFESVORDER NUMBER TYPE
site 001: Carmel Household Hazardous Wst, 901 N Range Line Rd, Carmel, IN 46032 -1361
10/13/2010 MDID007GR3 Medical Waste Service
11/01/2010 Steri -Safe OSHA Economy MTH
VOUCHER 106622 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
4002108657 01- 736H -08 5130.13
Voucher Total $130.13
Cost distribution ledger classification if
claim paid under vehicle highway fund
a
Prescribed by State Board of Accounts City Form fro. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i
An invoice or bill to be properly itemized must show, kind of service, where i
i
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 11/19/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11119/201( 4002108657 $130.13
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