Laserfiche WebLink
Oicycle, Inc. PAGE: 1 of 1 <br /> 13975 Polo Trail Dr, Suite 201 <br /> ru z =" Lake Forest, IL 60045 INVOICE DATE 04/01/2005 <br /> INVOICE NUMBER 0003193118 <br /> -0 ru <br /> CUSTOMER NUMBER 6059477 <br /> 'I Ex in Infection Control and Healthcare Compliance Services <br /> brj <br /> � P� P <br /> C:) PREVIOUS BALANCE $2,953.50 <br /> o FOR CUSTOMER SERVICE TOTAL ADJUSTMENTS -$1,969.00 <br /> Co MANTECA CARE&REHAB 866-STERI-CALL TOTAL NEW CHARGES $989.50 <br /> C3 ACCOUNTS PAYABLE 866-783-7422 <br /> 410 EASTWOOD AVE <br /> p MANTECA,CA 95336-3167 FOR PICK-UP INFORMATION TOTAL BALANCE DUE <br /> 800-MED-WASTE BY 05/01/2005 $1,974.00 <br /> 800-633-9278 <br /> 31111-U742"1HMOWPVQ2000406 =610A <br /> WEIGHMASTER CERTIFICATE: This is to certify that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature <br /> is on this certificate,and who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> CERTIFICATION:The material listed on the manifest#(s)details below(infectious medical waste)has been treated in accordance with the requirements of federal,state,and local <br /> 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. <br /> MANIFEST/ QUANTITY/ <br /> DATE ORDER NUMBER CONTAINERS DESCRIPTION WEIGHT PRICE TOTAL <br /> PR $2, 953.50 <br /> AD -$1, 969.00 <br /> 03/ � ¢ -$984.50 <br /> 03/ FACILITY -$984.50 <br /> INVOICE# D O" / <br /> GUMONTH t4-to. $9"-s-0 <br /> ACCT# AMOUNT <br /> NE � $989.50 <br /> siti <br /> Co Deputy Weightmester <br /> 04/ y, 0.00 LB $16.000 EA $16.00 <br /> 04/ TOTAL 71 /0 <br /> 0.00 LB $973.500 EA $973.50 <br /> 02l 11.30 LB $0.000 EA $0.00 <br /> 031 APPROVAL 1.80 LB $0.000 EA $0.00 <br /> $989.50 <br /> $0.00 <br /> $989.50 <br /> TOTAL BALANCE DUE BY 05/0112005 $1, 974.00 <br /> PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT IN THE ENCLOSED ENVELOPE <br /> AMOUNT ENCLOSED TOTAL BALANCE DUE BY 05/01/2005 <br /> $ $1,974.00 <br /> • CUSTOMER NUMBER INVOICE DATE INVOICE NUMBER <br /> -00 6059477 04/01/2005 0003193118 <br /> 00 Stericycle® CHECK CARD USING FOR PAYMENT <br /> •®• Stericycle, Inc. W <br /> 13975 Polo Trail Dr, Suite 201 ❑MASTERCARD ODISCOVER VISA AMERICAN EXP S CODEry <br /> Lake Forest, IL 60045 CARD NUMBER EXP.DATE <br /> RETURN SERVICE REQUESTED SIGNATURE PRINTED NAME <br /> 0006059477 0003193118 0000098950 3 030009 <br /> ADDRESSEE: REMIT TO: <br /> IItIIIIIIIIIIIIIIIiIIIIIIIIIIIIIIIIIIII11 111 IIIIIIIIIIIIIi1II IIIIIIIII LiIIIIIIIIIIIIliitll 1111lillllilllillilllollIIIII111 <br /> MANTECA CARE&REHAB STERICYCLE, INC. <br /> ACCOUNTS PAYABLE P.O. BOX 79145 <br /> 410 EASTWOOD AVE <br /> MANTECA,CA 95336-3167 PHOENIX, AZ 85062-9145 <br /> Ill, Ill Ill 111.IIIIIIIl111Il11 <br /> 31111-U74211HMOWPV02000406 1HM0WX58K:1.1 l qN <br />