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CSG SK-SSL-BOX-21 Brandon J Gaither 02/10/20 12:45 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# OR12254 O'Reilly # 3810 82338611-2000629549 <br /> 1551 W Main St SRVC WEEK: 2020-9 <br /> Ripon CA 95366-3012 SRVC DATE: 02/10/20 <br /> PHONE 972-555-1640 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> OR10217 O'Reilly Auto Parts <br /> 233 S Patterson Ave <br /> Attn John Bounds <br /> Springfield MO 65802-2210 <br /> PHONE 972-265-2485 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 40559605/ <br /> 875460 CNO-NON HAZARDOUS SOLID 5 1.000 <br /> SERVICE TERM 24 WEEK <br /> # CONTS: 1 TSDF: SJ MANIFEST#: 007314507SKS FORM CD: US SHIP# 230662859 <br /> CNT#: 200207626898 QTY: 140 WT/VOL P PROF# 40559605 SKDOT 7361257 <br /> 8003369 DRUM, 55 GL BLACK STEEL 0 1.000 <br /> SERVICE TERM 24 WEEK <br /> 3383 DRUM,55 GAL FOR O.F. 1.000 <br /> SERVICE TERM 24 WEEK <br /> 83383 DRUM,55 WASTE O.F. 1.000 <br /> SERVICE TERM 24 WEEK <br /> 100001 FEE, FUEL SURCHARGE 1.000 <br /> 100065 E-Manifest Fee 1.000 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 1.000 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS <br /> TOTAL CHARGE <br /> CREDITS <br /> --------------- <br /> TOTAL DUE <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT <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 />