222584 07/30/2013 F CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1
`q 0 ONE CIVIC SQUARE STERICYCLE INC CHECK AMOUNT: $37.92
CARMEL, INDIANA 46032 PO BOX 6575
CAROL STREAM IL 60197-6575 CHECK NUMBER: 222584
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 4004235605 37 . 92 OTHER CONT SERVICES
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STERICYCLE,INC. (866)783-7422 PAGE:2 of 2
CARMEL CLAY PARKS AND RECR CUSTOMER#: 2245380 INVOICE#: 4004235605 INVOICE DATE: 06/30/2013
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
06124/2013 MDIDOOA1YF 1.00 17x20x22 Large Box Disposal 0.00 lb $32.500 EA $32.50
06124/2013 MDIDOOAIYF 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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PAGE: 1 of 2
O O I N V®ICE INVOICE DATE 06/3012013
Q O Q Sterkyde* INVOICE NUMBER 4004235605
O Protecting People.Reducing Risk: CUSTOMER NUMBER 2245380
o O
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#221253 06/21/2013 ($37.92)
Cuok NT:INVOICE:CHARGES >::,;:. .......... ; ::...: : : : ;(Seg:Reverse;P,.age For
TOTAL ACCOUNT BALANCE DUE BY 07/30/2013 $37.92 °
JUL --8 2013
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 WI,this invoice also serves as
a certificate of destruction.
Account History Please disregard if payment has been sent.
1-30 days 31-60 days 61-90 days 90+days Total Account
> ...... t;,; 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.
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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
6/30/13 4004235605 Regulated medical waste $ 37.92
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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 Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1094 4004235605 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
25-Jul 2013
Signature
$ 37.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund