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CSG SK-SSL-BOX-21 Brandon J Gaither 09/12/17 10:15 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# CA39985 Cal West Concrete Cutting 74729123-1704540834 <br /> 1153 Vanderbilt Cir SRVC WEEK: 2017-37 <br /> Manteca CA 95337-6120 SRVC DATE: 09/12/17 <br /> PHONE 209-823-2236 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> CA39985 Cal West Concrete Cutting <br /> 1153 Vanderbilt Cir <br /> Manteca CA 95337-6120 <br /> PHONE 209-823-2236 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL '.. <br /> PRODUCT QTY UNIT PRICE TAX CHARGE '.. <br /> 3383 DRUM,55 GAL FOR O.F. 1.000 21.2000 0.00 21.20 <br /> SERVICE TERM 24 WEEK <br /> 83383 DRUM,55 WASTE O.F. 1.000 108.1600 0.00 108.16 <br /> SERVICE TERM 24 WEEK '.. <br /> 100001 FEE, FUEL SURCHARGE 1.000 10.8300 0.00 10.83 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 1.000 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 140.1900 0.00 140.19 '.. <br /> TOTAL CHARGE 140.19 <br /> CREDITS 0.00 <br /> -------------- <br /> i <br /> TOTAL DUE 140.19 <br /> UNPAID BALANCE THIS RECEIPT 140.19 <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 (18a 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 /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> Page 35 <br />