207229 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
I 0 ONE CIVIC SQUARE STERICYCLE INC CHECK AMOUNT: $190.16
CARMEL, INDIANA 46032 PO BOX 6575
CAROL STREAM IL 60197 -6575 CHECK NUMBER: 207229
CHECK DATE: 3/1312012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4003203633 190.16 OTHER EXPENSES
PAGE: 1 of
I NVOICE INVOICE DATE 03/0172012
0 cop INVOICE NUMBER 4003203633
o 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
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $190.16
CURRENT ADJUSTMENTS ($190.16)
Thank You Payment #206451 0212712012 ($190.16)
CURRENT INVOICE CHARGES TAXABLE
CURRENT INVOICE CHARGES NON TAXABLE
S1eri -Safe 0310112012 $190.16
TAX TOTAL $0.00
CURRENT INVOICE CHARGES Includes SIerI Saf ®f?SHA Compliance See ,Next P60'-'For Deta:ilsj $190 16
TOTAL ACCOUNT BALANCE DUE BY 0313112012 $190.16
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 A2, 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 Y;f 1 -30 days 31 -60 days 61 -90 days W 90+ days Total Account
k Past Due Past Due Past Due Past Due Balance
:$1'416s3: $0.00 $0.00 $0.00 $0.00 $190.16
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.
•sYa ...............im— P0.aYM0rr i...ei•■...o.fe.. own---
STERICYCLE, INC. (866) 783 -7422 PAGE: 2 of 2
CARMEL WASTE WATER UTILITY CUSTOMER 1016766 INVOICE 4003203633 INVOICE DATE: 03101/2012
SERVICE SUMMARY
DATE MANIFEST /ORDER NUMBER TYPE
Site 001: Carmel Household Hazardous Wst, 901 N Range Line Rd, Carmel, IN 46032 -1361
03/01/2012 Steri -Safe Economy Monthly
Economy Level Monthly Billing includes:
Medical Waste Services Medical Waste Training Manifest Archives
03/01/2012 Environmental /Regulatory Fee
VOUCHER 116903 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
4003203633 01- 736H -08 $190.16
Voucher Total $190.16
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 3/5/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/5/2012 4003203633 $190.16
1 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