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r <br />CSG SK -SSL -BOX -23 <br />Raymond Gomez <br />11/09/18 12:53 PAGE 1 <br />afety-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 />CUSTOMER# DE54220 <br />BILL TO CUSTOMER# <br />10 <br />DE54220 <br />PURCHASE ORDER# <br />SERVICE/ <br />PRODUCT <br />3102761 <br />100030 <br />100009 <br />1 <br />21E520X-PSB-DR55-VT <br />00006 <br />Delgado Auto <br />1 W Dr Martin Luther Ki <br />Stockton CA 95206-1703 <br />PHONE 760-579-1533 <br />BILL TO ADDRESS: <br />Delgado Auto <br />101 W Dr Martin Luther King Jr Blvd <br />Stockton CA 95206-1703 <br />PHONE 760-579-1533 <br />PCEO <br />SERVICE TERM 24 WEEK <br />RECOVERY FEE <br />Motor oil Assessment Fee <br />Oil Recycling Fee >70% BASE <br />TOTAL SERVICE/PRODUCTS <br />QTY UNIT PRICE <br />1.000 386.2700 <br />REFERENCE NBR. <br />78430553 <br />SRVC WEEK: 2018-45 <br />SRVC DATE: 11/09/18 <br />TAX EXEMPT# <br />TOTAL <br />TAX CHARGE <br />34.76 421.03 <br />1.000 0.0000 <br />1.D00 2.7500 <br />1.000 6.6000 <br />0.00 <br />0.00 <br />0.00 <br />0.00 <br />2.75 <br />6.60 <br />---------------------------------------- <br />395.6200 <br />34.76 <br />430.38 <br />TOTAL CHARGE <br />CREDITS <br />TOTAL DUE <br />UNPAID BALANCE THIS RECEIPT 430.38 <br />GENERATOR STATUS <br />0-220 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 />amounts outstanding. Customer certifies that the individual signing <br />this Service Acknowledgement is duly authorized to sign and bind <br />Customer. Customer acknowledges that it is responsible for maintaining <br />its Generator Status and obtaining an EPA ID number if required by <br />430.36 <br />0.00 <br />430.38 <br />