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r � u `IMMEDIATE ACTION REQUIRED"** <br /> *.00 Stericycle 1 Read the attached Terms and Conditions along with the Waste Acceptance Poli <br /> 2)Choose and circle your desired service level. <br /> o Protecting People.Reducing Risk 3)Please Fax Agreement to Stericycle(866)445-0389. <br /> STERI SAFES*Service Agreement <br /> ;Custme <br /> or �iSan Joaquin Delta College Customer# 6019710 <br /> !Addr5151 Pacific Ave jSite ID#: 02 i <br /> ;City/State/Zip: ;Stockton,CA 952076304 Phone# <br /> � � �(209)954-5835 <br /> ail Fax# <br /> Sales Rep _ Jamin McGlnnis Generator ID# <br /> Generated I im)n McGinnis (Contract Number: 1;SRCL-00311429 <br /> STERI-SAFE PROGRAM BENEFITSEconomy I <br /> Medical Waste Pickup and Disposal <br /> [- Complete Documentation(Manifests and Tracking Documents) <br /> i -y Flat Monthly Fee <br /> Custom Scheduled Service Frequencies(2,3,4,6,13,26,or 52 Stops/Year,or Daily Stops) <br /> SteriSafe.com Online tools for OSHA Compliance information. (If Manual is required ask rep for details) <br /> Interactive Multimedia Bloodbome Pathogens Training on CD-ROM --'-�I�,1 <br /> Quarterly Audio Safety Meetings on Critical and Timely Safety Topics <br /> Hazard Communication Poster and Secondary Labels <br /> Product Discounts(Sharps containers,Safety Products etc.) <br /> MSDS System on the web,Updated Annually <br /> Mock OSHA Evaluation,Including Written Recommendations <br /> On-Site Annual OSHA Training with a Qualified Occupational Safety Specialist(May qualify for CE Units) —'—Ij- <br /> 1 Guarantee--If by following our program you are found not to be in compliance with OSHA,Stericycle will pay your fine!(as It ! <br /> pertains to BBP) �! <br /> *** $Per Month <br /> E (nxnsa CIRCLE ONE) <br /> =$1,622.00 <br /> --1 <br /> Estimated Stops per Year:52 -- <br /> �� $/Eanal I <br /> Containers � <br /> (A charge of 575.00 will be added for each addl.stop) Estimated Yearly IFch additio <br /> Z Steri-Safe_ i -... <br /> ! Containers 1 container � <br /> Maximum Medical Waste Containers per Year:104 __ j <br /> i- � �..�._ A Payment Schedule(Please Check One):[XI Monthly[I Quarterly[1 Annually �W I 104 $35.00 <br /> Contract Effective Date:2017-07 01 <br /> Any additional services or products selected by Customer shall be billed separately <br /> according to current Stericycle pricing. <br /> Customer certifies that they will properly classify and segregate their special waste <br /> streams and that they will not co-mingle those waste streams with any other. <br /> By signing below I acknowledge that I am Customer's authorized officer or agent and that I have the authority to bind Customer to this Agreement.Customer agrees to be <br /> bound by the terms an i s tha p ejonsecond page hereof and comply with Stericycle's Waste Acceptance Policy,both of which are integral parts of this <br /> Agreement.(Appendix A). f" �2 <br /> CUSTOMER:X Name ?i&kL& Titlel -^I-1 5 1 [f.�*ll ��a'?' <br /> ST Name Jamin McGinnis Title Date <br /> Stericycle reserves the rig to deal solely with the Customer and not with any third party agents of the customer for all purposes relating to this agreement. <br /> Customer represents and warrant to Stericycle that it is the medical waste generator and is acting for its own account and not through a broker or agent.Stericycle <br /> shall be entitled to terminate this agreement and seek all available legal remedies,including but not limited to liquidated damages,in the amount set forth herein for <br /> Customer's breach of this representation and warranty. <br /> 4010 Commercial Ave.,Northbrook,IL 60062•Phone:(847)943-6706•Fax:(866)445-0389 <br /> Offer Expiration Date:6-23-2011 <br /> Office Use Only:Code#:RX-1.0.FC-I.OYD-I.O.M.1.0 <br />