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e <br />0 Protecting People. Reducing Risk. <br />HAMPTON CARE CENTER <br />ACCOUNTS PAYABLE <br />442 E. HAMPTON ST <br />STOCKTON, CA 95204 <br />Page: 9 of 1 <br />INVOICE INVOICE DATE 11/30/2010 <br />INVOICE NUMBER 3001202408 <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@Stedeycle.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 Standards of the California Department of Food and Agriculture. <br />ACCOUNT SUMMARY <br />DESCRIPTION DATE AMOUNT TOTAL <br />PREVIOUS BALANCE $1,924.76 <br />CURRENT ADJUSTMENTS ($1,924.76) <br />Payment -Ref #TRS01 1811 08/11/2010 ($1,090.95) <br />Payment -Ref #012064 10/20/2010 ($831,69)1 <br />f <br />Misc. Credit -Ref #3001154317 11/03/2010 ($2.12) <br />CURRENT INVOICE CHARGES (SEE REVERSE SIDE FOR DETAILS) $1,018.17' <br />TOTAL ACCOUNT BALANCE DUE BY 12/30/2010 $1,018.17 <br />CERTIFICATION: The matejriallisted on the manifest(s) (infectious medical waste) has been treated in accordance with tile requirements of federal, state, and local regulations governing the <br />treatment of such wester, to copy of this certificate, applicable manifests, and the appropriate logs will remain on file with the company. For customers In AZ, MO, NM, NY, PA, PR, and WI, this <br />invoice also �erves bs a certification of destruction. <br />�S) <br />Account History <br />Current <br />1 - 30 days <br />Past Due <br />31 - 60 days <br />Past Due <br />61 - 90 days <br />Past Due <br />90+ days <br />Past Due <br />Total Account <br />Balance <br />$1,018.17 <br />$0.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$1,018.17 <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 />00 <br />teic ce® <br />00 <br />® STERICYCLE, INC. <br />28161 N. KEITH DRIVE <br />LAKE FOREST, IL 60045 <br />�-7 If account or contact Information has changed please <br />L —1 check box and fill out back portion of coupon <br />DR <br />Ref: 341 STUBH004010 - 2 <br />HAMPTON CARE CENTER <br />ACCOUNTS PAYABLE <br />442 E. HAMPTON ST <br />STOCKTON, CA 95204 <br />INVOICE NUMBER <br />3001202408 <br />INVOICE DATE <br />11/30/2010 <br />CUSTOMER NUMBER <br />6080852 <br />TOTAL ACCOUNT BALANCE DUE BY 12130/2010 <br />$1,018.17 <br />TOTAL AMOUNT ENCLOSED <br />$ <br />7®I[+ AMERIGaIV SECURITY CODE <br />Y®.i _ E70�RE55 <br />CARD NUMBER <br />EXP DATE <br />r <br />SIGNATURE <br />PRINTED NAME <br />REMIT TO: <br />111111111 1 it III III III III <br />STERICYCLE, INC. <br />P.O. BOX 900`1589 <br />LOUISVILLE,40290-1589 <br />