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224133 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 00352121 Page 1 of 1 ONE CIVIC SQUARE STERICYCLE INC 0 CHECK AMOUNT: $39.82 CARMEL, INDIANA 46032 PO BOX 6575 CAROL STREAM IL 60197-6575 CHECK NUMBER: 224133 CHECK DATE: 911012013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1094 4350900 4004337355 39 . 82 OTHER CONT SERVICES PAGE: 1 of 2 o INVOICE INVOICE DATE 08/26/2013 &00000 Stericyde* INVOICE NUMBER ,40043373,55 protecting People.Reducing Risk: CUSTOMER NUMBER 2245380 Site Information omReverse Page CARMEL CLAY PARKS AND RECR [IUA 7, 4 b � a� or billing,scheduling or customer service: ACCOUNTS PAYABLE (866 700 AM-2 1411 E 116TH ST 2013 Hours:(Mon-Fri)7:00 AM-6:00 PM CST CARMEL IN 46032-3455 CustomerCare @Stericycle.com B� ACCOUNT SUMMARY DESCRIPTION DATE AMOUNT TOTAL PREVIOUS BALANCE $119.46 CURRENT ADJUSTMENTS ($79.64) e Thank You-Payment#223216 08/16/2013 ($79.64) CURRENT INVOICE CHARGES (See Reverse Page For Details) $39.82 TOTAL ACCOUNT BALANCE DUE BY 09/25/2013 $79.64 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. Current 1-30 days 31-60 days 61-90 days 90+days Total Account Past Due Past Due Past Due Past Due Balance $79.64 $0.00 $0.00 $0.00 $0.00 $79.64 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#: 4004337366 INVOICE DATE: 08/2612013 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 08/16/2013 MDIDOOA707 1.00 17x2Ox22 Large Box Disposal 0.00 lb $34.125 EA $34.13 08/16/2013 MDIDOOA707 1.00 Energy Charge 0.00 lb $5.690 EA $5.69 Site 001:SUB TOTAL $39.82 Site 001:TAX TOTAL $0.00 Site 001:. TOTAL $39.82 TOTAL CURRENT INVOICE CHARGES $39.82 io9�-�.��ogno 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 8/26/13 4004337355 Regulated medical waste 8/16/13 $ 39.82 Total $ 39.82 I hereby certify that the attached invoice(s), or bills)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$ $ 39.82 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1094 4004337355 4350900 $ 39.82 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 5-Sep 2013 Signature $ 39.82 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund