196561 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
ONE CIVIC SQUARE STERICYCLE INC
CARMEL, INDIANA 46032 PO BOX 9001588 CHECK AMOUNT: $130.13
LOUISVILLE KY 40290 -1588
CHECK NUMBER: 196561
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4002461356 130.13 OTHER EXPENSES
Page: 1 of 2
O0 I INVOICE DATE 04/01/2011
1 0 Sterlc yde' INVOICE NUMBER 4002461356
X 0 Protecting People. Reducing Risk: CUSTOMER NUMBER 1016765
CARMEL WASTE WATER UTILITY
JOHN DUFFY For billing, scheduling or customer service:
760 3RD AVE SW J (866) 783 7422
CARMEL, IN 46032 2584 Hours: (Mon Fri) 7:00 AM 7:00 PM CST
CustomerCare@Stericycle.com
GO PAPERLESS, ENROLL NOW at WWW.VUERILL.COM /STERICYCLE
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $260.26
CURRENT ADJUSTMENTS ($260.26)
Payment-Ref #194777 02/25/2011 ($130.13)
Payment -Ref #195663 03/25/2011 ($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 0510112011 $130.13
CERTIFICATION: The material listed on the manifest(s) (infectious medical waste) has been treated in accordance w th 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
$13013 $0.00 $0A0 $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 1016765 INVOICE 4002461356 INVOICE DATE: 0410112011
SERVICE SUMMARY
DATE MANIFESTIORDER NUMBER TYPE
Site 001: Carmel Household Hazardous Wst, 901 N Range Line Rd, Carmel, IN 46032 -1361
03/09/2011 MDID007TWI Medicai Waste Service
04101/2011 Steri -Safe OSHA Economy MTH
VOUCHER 107465 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
4002461356 01- 736H -08 $130.13
Voucher Total $130.13
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 4/6/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/6/2011 4002461356 $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