214830 11/20/2012 ��•., CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
ONE CIVIC SQUARE STERICYCLE INC
CARMEL, INDIANA 46032 PO Box 6576 CHECK AMOUNT: $37.92
as�° CAROL STREAM IL 60197-6575 CHECK NUMBER: 214830
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 4003716722 37 . 92 OTHER CONT SERVICES
PAGE: 1 of 2
6o INVOICE INVOICE DATE 10/17/2012
0p St eift de' INVOICE NUMBER 4003716722
O coProtecting People.Reducing Risk: CUSTOMER NUMBER 2245380
Site Information on Reverse Page
CARMEL CLAY PARKS AND RECR �y For billing,scheduling or customer service:
CCOUNTS PAYABLE �/ (866)783-7422
A
AC 1 E TH ST Hours:(Mon-Fri)7:00 AM-6:00 PM CST —
CARMEL IN 46032-3455 CustomerCare @Stericycle.com
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $37.92
CURRENT ADJUSTMENTS $0.00 e
CURRENT INVOICE CHARGES (See Reverse page For Details) $37 92'::
.. .... —
. . -
TOTAL ACCOUNT BALANCE DUE BY 11/16/2012 $75
Purchase ��� MEdt�A{—yJAST�-x'12
Description V D
P.O.# P or F �e
Q9 +- �l3 00 OCT 2 2 Z01Z
t-in "D G`4-e5- CU7'T�r S�CS
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Purchaser Date
Approval Date
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 togs 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.
Curie..... .: 1-30 days 31-60 days 61-90 days 90+days Total Account
Past Due Past Due Past Due Past Due Balance
>.$75.84.::..;:: $0.00 $0.00 $0.00 $0.00 $75.84
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 CLAY PARKS AND RECR CUSTOMER#: 2245380 INVOICE#: 4003716722 INVOICE DATE: 10/1712012
DATE MANIFEST/ QUANTITY/ DESCRIPTION WEIGHT PRICE TOTAL
ORDER NUMBER CONTAINERS
Site 001: Carmel Clay Parks and Recr, 1235 Central Park Dr E,Carmel,IN 46032-4421
10/12/2012 MDID0099JR 1.00 17x20x22 Large Box Disposal 0.00 lb $32.500 EA $32.50
10112/2012 MDID0099JR 1.00 Energy Charge 0.00 lb $5.420 EA $5.42
10/12/2012 MDID0099JR 1.00 Record Retention Fee 0.00 lb $0.000 EA $0.00
10112/2012 MDID0099JR 1.00 Minimum Pick-up Fee 0.00 lb $0.000 EA $0.00
Site 001:SUB TOTAL $37.92
Site 001:TAX TOTAL $0,00
Site 001: TOTAL $37.92
TOTAL CURRENT INVOICE CHARGES $37.92
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; k nd of service,units, price performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour.
Payee Purchase Order No.
Terms
00352121 Stericycle, Inc.
P.O. Box 6575
Carol Stream, IL 60197-6575
Invoice Description PO# Amount
Invoice (or note attached invoice(s) or bill(s))
Date Number $ 37.92
10117112 4003716722 Reclulated medical waste Oct'12
Total $ 37.92
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
120—
Clerk-Treasurer
I
Voucher No. Warrant No.
00352121 Stericycle, Inc. Allowed 20
P.O. Box 6575
Carol Stream, IL 60197-6575
In Sum of$
$ 37.92
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 4003716722 4350900 $ 37.92 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
15-Nov 2012
Signature
$ 37.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund