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%6900Stericycle° <br />es Protecting People. Reducing Risk. <br />HAMPTON CARE CENTER <br />ACCOUNTS PAYABLE <br />442 E. HAMPTON ST <br />STOCKTON, CA 95204 <br />YOUR ACCOUNT REFLECTS A BALANCE 30 DAYS PAST DUE <br />11Tj� <br />Page: 1 of 2 <br />INVOICE DATE 01/31/2010 <br />INVOICE NUMBER 3000800652 <br />CUSTOMER NUMBER 6080852 <br />For billing, scheduling or customer service: <br />(866) 783-7422 <br />■ Hours: (Mon - Fri) 7:00 AM - 7:00 PM CST <br />CustomerCare@Stericycle.com <br />WEIGHMASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose signature is on this <br />certificate, and who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, <br />administered by the Division of Measurement Sarldard�s of the California Department of Food and Agriculture. <br />ACCOUNT SUMMARY <br />DESCRIPTION DATE <br />PREVIOUS BALANCE <br />CURRENT ADJUSTMENTS <br />CURRENT INVOICE CHARGES (SEE REVERSE SIDE FOR DETAILS) <br />TOTAL ACCOUNT BALANCE DUE BY 03/02/2010 <br />CERTIFICATION: The material listed on the manifest(s) (infectious medical waste) has been treated in accordance with the require <br />treatment of such waste. A copy of this certificate, applicable manifests, and the appropriate logs will remain on file with the companj <br />invoice also serves as a certification of destruction. <br />Account History <br />Current <br />1 - 30 days 31 - 60 days <br />61 - 90 days <br />90+ days Total Account <br />STERICYCLE, INC. <br />Past Due Past Due <br />Past Due <br />Past Due Balance <br />$971.95 <br />$972.92 $0.00 <br />$0.00 <br />$0.00 I $1,944.87 <br />AMOUNT TOTAL <br />$972.92 <br />$0.00 <br />$971.95 <br />$1,944.87 <br />ACCOUNTS PAYABLE <br />CONFIRM RECEjPT. PRICES AND QU NTi <br />:DEPAR'VIENHEAD OATI <br />A OVAID FOR PAYE T: <br />ADMINISTRATOR ;OATS <br />FOR ACCOUNTING -USE ONLY - <br />VENDOR NUMBER °` pt�a:• <br />ACCOUNTING DATE' i <br />GL CODES <br />�t� A�AQ° eAexep <br />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 MAIL] <br />t <br />00 <br />CUSTOMER NUMBER <br />6080852 <br />00 <br />terecycle` <br />®00 <br />STERICYCLE, INC. <br />— <br />e 'VSA AMERICAN SECURITY CODE' <br />_ E7SPRE55 <br />CARD NUMBER EXP DATE <br />28161 N. KEITH DRIVE <br />LAKE FOREST, IL 60045 <br />If account or contact information has changed please <br />check box and fill out back portion of coupon <br />i <br />INVOICE NUMBER INVOICE DATE <br />3000800652 01/31/2010 <br />CUSTOMER NUMBER <br />6080852 <br />TOTAL ACCOUNT BALANCE DUE BY 03/02/2010 <br />$1,944.87 <br />TOTAL AMOUNT ENCLOSED <br />$ <br />— <br />e 'VSA AMERICAN SECURITY CODE' <br />_ E7SPRE55 <br />CARD NUMBER EXP DATE <br />SIGNATURE PRINTED NAME <br />0006080852 3000800652 0000097195 3 030007 <br />ADDRESSEE: <br />fill IIIIIII111111■I1IIILIIILIILIIIIIIIIIIIIJIIIIILIIIII <br />REMIT TO: i <br />�11nIIluIIIIIIIIlnlluIIIIIIIIIIIInlllll [III III IilIuIIIII <br />Rcr:035STUB0004491 -3 <br />HAMPTON CARE CENTER STERICYCLE, INC. <br />ACCOUNTS PAYABLE P.O. BOX 9001589 <br />442 E. HAMPTON <br />STOCKTON, CA 95522 04 LOUISVILLE, KY 40290-1589 <br />