201428 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
ONE CIVIC SQUARE STERICYCLE INC CHECK AMOUNT: $158.08
CARMEL, INDIANA 46032 PO BOX 6575
CAROL STREAM IL 60197.6575 CHECK NUMBER: 201428
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4002799950 158.08 OTHER EXPENSES
PAGE: 1 of 2
INVOICE INVOICE DATE 09/01/2b11
Stericycle• INVOICE NUMBER 4002799950,=
m Protecting People. Reducing Risk.
CUSTOMER NUMBER' 1016765
CARMEL WASTE WATER UTILITY For billing, scheduling or customer service:
JOHN DUFFY (866) 783 -7422
760 3RD AVE SW Hours: (Mon Fri) 7:00 AM 6:00 PM CST
CARMEL IN 46032 -2584 CustomerCare @Stericycle.com
PLEASE MAKE SURE THAT YOUR RECORDS HAVE BEEN UPDATED WITH THE CURRENT STERICYCLE REMIT TO ADDRESS AS NOTED IN THE REMITTANCE PORTION OF THIS
INVOICE.
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $288.21
CURRENT ADJUSTMENTS ($288.21)
Thank You Payment #199692 08/0512011 ($130.13)
Thank You- Paymenl #200638 08/29/2011 ($158.08)
CURRENT INVOICE CHARGES TAXABLE
CURRENT INVOICE CHARGES NON TAXABLE k*
Steri -Safe 09/01/2011 $158.08
TAX TOTAL $0'00
CURRENT INVOICE CHARGES IncEudesSLeii -Safe OSHAComplrance, (See, Next Pa ge:F or De tails} $158.08<
TOTAL ACCOUNT BALANCE DUE BY 10101/2011 $158.08
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, PA, PR, and WI,
this invoice also serves as a certification of destruction.
Account History Please disregard if payment has been sent.
Current: 1 30 days 31 60 days 61 90 days 90 +days Total Account
Past Due Past Due Past Due Past Due Balance
$158Q8 0.00 $0.00 $0.00 $0.00 $158.08
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 1016766 INVOICE 4002799950 INVOICE DATE: 09/01/2011
SERVICE SUMMARY
DATE MANIFEST /ORDER NUMBER TYPE
Site 001. Carmel Household Hazardous Wst, 901 N Range Line Rd, Carmel, IN 46032 -1361 W
09/01/2011 Steri -Safe Economy Monthly
Economy Level Monthly Billing Includes:
Medical Waste Services Medical Wasle Training Manifest Archives
09101/2011 Environmental Regulatory Fee
VOUCHER 115764 WARRANT ALLOWED
352121 IN SUM OF
STERICYCLE INC.
P.O. Box 6575
Carol Stream, IL 60197
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
4002799950 01- 736H -08 $158.08
Voucher Total $158.08
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 6575 Terms
Carol Stream, IL 60197 Due Date 9/6/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/6/2011 4002799950 $158.08
hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and audited same in accordance with S IC 5- 11- 10 -1.6
ll
iellI
Date Officer