MONTHLY REBATE STATEMENT CHECK

Month: ________   Buyer: ________________   Statement received: ________

[ ] 1. INDEX
       Value used: $______  Publication/region/side/month match contract §__?
[ ] 2. LOADS
       Loads on statement: ____  Loads in our log: ____  All ticket numbers present?
[ ] 3. WEIGHTS
       Each ticket shows gross, tare, net? Ton definition matches contract (____ lb)?
       Our bale count x avg bale weight ~ statement net weight? (+/- ____%)
[ ] 4. PRICE
       Formula applied as written: ____________________ = $______ per ton
       Floor / cap applied correctly?
[ ] 5. MOISTURE
       Any deductions? Reading, method and load number shown?
[ ] 6. QUALITY CLAIMS
       Any claims? Notice received within ____ days? Photos and measured %?
       Only excess weight deducted (unless rejection threshold exceeded)?
[ ] 7. FREIGHT
       Charged as contract allows (in price / per load / per ton)? Fuel surcharge basis?
[ ] 8. EQUIPMENT
       Monthly charge correct? Any days out of service credited?
[ ] 9. PAYMENT
       Paid or credited on time? Credit beyond invoice paid out?
[ ] 10. DISPUTE
       Anything to dispute? Dispute window closes: ________. Sent: ________

Notes:
______________________________________________________________________

This template is a starting point for a negotiation, not legal advice. Have the final agreement reviewed by your own counsel.
Source: recyclingcontracts.com