217828 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
ONE CIVIC SQUARE STERICYCLE INC
CHECK AMOUNT: $37.92
s. �+a CARMEL, INDIANA 46032 Po BOX 6575
CAROL STREAM IL 60197-6575 CHECK NUMBER: 217828
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 4003955430 37 . 92 OTHER CONT SERVICES
STERICYCLE,INC. (866)783-7422 PAGE:2 of 2
CARMEL CLAY PARKS AND RECR CUSTOMER#: 2245380 INVOICE#: 4003955430 INVOICE DATE: 02111/2013
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
02/01/2013 MDID009MBI 1.00 17x20x22 Large Box Disposal 0.00 lb $32.500 EA $32.50
02/01/2013 MDID009MBI 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
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Line Descr SI/GS,
Purchaser
Date
Approval_____
---__.___,_Data
PAGE:1 of 2
0 o INVOICE INVOICE DATE 02/11/2013
0
O O 0 Steiric�} de' INVOICE NUMBER 4003955430
O CUSTOMER NUMBER 2245380
Protecting People.Reducing Risk:
� Site Information on Reverse Page
,
C' �-T F•-% For billing,scheduling or customer service:
CARMEL CLAY PARKS AND RECR (866)783-7422
ACCOUNTS PAYABLE FEB 14 2013 ® Hours:(Mon-Fri)7:00 AM-6:00 PM CST
1 4 1 1 E 116TH ST I CustomerCare @Stericycle.com
CARMEL IN 46032-3455 —
ACCOUNT SUMMARY
DESCRIPTION DATE AMOUNT TOTAL
PREVIOUS BALANCE $37.92
CURRENT ADJUSTMENTS $0.00
CURRENT INVOICE CHARGES (See Reverse Page For Details) $37.92
TOTAL ACCOUNT BALANCE DUE BY 03/13/2013 $75.84 p
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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 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
$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.
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 Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/11/13 4003955430 Regulated medical waste $ 37.92
Total $ 37.92
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
120_
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#/TITLE AMOUNT Board Members
Dept#
1094 4003955430 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
21-Feb 2013
Signature
$ 37.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund