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CSG SK-SSL-BOX-24 Cole Taylor 12/07/17 12:28 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# DD02783 D & D Lift Inc. 75527770-1706201021 <br /> 3820 Rhonda Way SRVC WEEK: 2017-49 <br /> Tracy CA 95304-1608 SRVC DATE: 12/07/17 <br /> PHONE 209-229-7440 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> DD02783 D & D Lift Inc. <br /> 3820 Rhonda Way <br /> Tracy CA 95304-1608 <br /> PHONE 209-229-7440 <br /> PURCHASE ORDER# 14880 TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 3383 DRUM,55 GAL FOR O.F. 3.000 10.0000 0.00 30.00 <br /> SERVICE TERM 12 WEEK <br /> 83383 DRUM,55 WASTE O.F. 1.000 45.0000 0.00 45.00 <br /> SERVICE TERM 12 WEEK <br /> 898560 CARTRIDGE OIL FILTERS 55G 1.000 150.0000 0.00 150.00 <br /> SERVICE TERM 12 WEEK <br /> # CONTS: 1 TSDF: WI MANIFEST#: 006286250SKS FORM CD: US SHIP# 224162278 <br /> CNT#: 171111813923 QTY: 200 WT/VOL P PROF# 156033 SKDOT 7872676 <br /> 100001 FEE, FUEL SURCHARGE 1.000 12.1500 0.00 12.15 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 3.000 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 217.1500 0.00 237.15 <br /> TOTAL CHARGE 237.15 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 237.15 <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 237.15 <br /> GENERATOR STATUS <br /> 220-2200 lbs/month <br /> Customer certifies that (i) the above-named materials are properly <br /> classified, packaged, marked and labeled, and are in proper condition <br /> for transportation according to the applicable regulations of the <br /> Department of Transportation (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SK is authorized to charge Customer's account for <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (18% per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br />