217359 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
' ONE CIVIC SQUARE STERICYCLE INC CHECK AMOUNT: $37.92
`. % CARMEL, INDIANA 46032 PO Box 6575
CAROL STREAM IL 60197-6575 CHECK NUMBER: 217359
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 4003895835 37 . 92 OTHER CONT SERVICES
PAGE:1 of 2
COo INVOICE INVOICE DATE 01/14/2013
P Silericyde• INVOICE NUMBER 4003895835
Protecting People.Reducing Risk: CUSTOMER NUMBER 2245380
Site Information on Reverse Page
CARMEL CLAY PARKS AND RECR For billing,scheduling or customer service:
ACCOUNTS PAYABLE (866)783-7422
1411 E 116TH 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 ($37.92)
Thank You-Payment#216204 01/12/2013 ($37.92)
CURRENT INVOICE CHARGES.. (See Reverrise:Pag6 For.DetaAs} $37 92 a:
TOTAL ACCOUNT BALANCE DUE BY 02113/2013 $37.92
D�= cript;on --
'.O.# P Or F 7- T1�D
G.L.# l09y• 4350 900
Budcet � JAN 1 7 2013
i_ine Descr
Purchaser Date BY.� __��
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 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.
.Cuirerit 1-30 days 31-60 days 61-90 days 90+days Total Account
Past Due Past Due Past Due Past Due Balance
$37:92::::'': $0.00 $0.00 $0.00 $0.00 $37.92
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 M 2245380 INVOICE M 4003895835 INVOICE DATE: 01/1412013
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
01/04/2013 MDID009,13Z 1.00 17x20x22 Large Box Disposal 0.00 lb $32.500 EA $32.50
01/04/2013 MDID009,13Z 1.00 Energy Charge 0.00 lb $5.420 EA $5.42
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; kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
00352121 Stericycle, Inc. Terms
P.O. Box 6575
Carol Stream, IL 60197-6575
Invoice M4003895835 Description
Date te attached invoice(s) or bill(s)) PO# Amount
1/14/13 jR;eguIa;te;dmedicaI waste Jan'13 $ 37.92
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
20_
Clerk-Treasurer
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#1TITLE AMOUNT Board Members
Dept#
1094 4003895835 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
7-Feb 2013
Signature
$ 37.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund