The URL can be used to link to this page

Home My WebLink About229962 03/12/14 CITY OF CARMEL, INDIANA VENDOR: 357526 CHECK AMOUNT: S 431.50' ONE CIVIC SQUARE HENRY SCHEIN INC ��""�`�"�CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 229962 (9, PALATINE IL 60055-0241 CHECK DATE: 03/12/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 6731112-01 431.50 SPECIAL DEPT SUPPLIES ORDER# I ORDER DATE �QUE.DATE ,— 16520063 141 D&B#:01-243-0880 WHSEDEA# RHO162494 Fed ID: 11-3136595 SO :11 mlmf� .:,.i,,. 001�941 RI g ON, ". 0 1511, ,Ell rhis order as been processed by our MIDWEST D.C. 5315 WES" 74TH 3TREET INDIANAPODLIS,IN 46268 rOM SMALL 317-571-2663 1 107-0530 100/BX PURPLE NITRILE PF GLOVE LARGE so 50 *C 8.63 431.50 5 -_ASE GOOD IPEM, MAY BE SHIPPED SEPARATELY. rHE PRICES 3TATED ABOVE MAY REFLECT A DISCOUN" OR BE SUBJECT TO A REBATE YOU AUST FULLY kND ACCURATELY REPORT THIS STATED EISCOUNC PRICE, OR IF APPLI(ABLE, kNY NET PRI-ING, AFTER GIVING EFFECT TO ANY REBATES, TO MEEICARE, MEDICAID, rRICARE AND ANY OTHER FEDERAL OR STATE PROGRAM UPON ZEQUES7 BY ANY SUCH IROGRAM. IT ISYOUR ESPONSIBILITY TO REVIEW ANY AGREEMENTS OZ OTHEF DOCUMENTS AP LICABLE TO THESE PZICES TO DETERMINE IF THEY ARE SUBJECT TO A REB TE. THE FEDEPAL OVERNMENTI4POSES CERTAIN RESTRICTIONS ON, AND REQUI;ZES PUELIC REPORTING OF, rRANSFERS 07VALUE TO A PRACTITIONER. IF YOU ARE PART ECIPATING IN A PROMOTIONAL DISCOUNT PR GRAM (E.G. POINTS, DISCOUNT REDEMPTIONS DR OTHER SPECIAL AWARDS) , tqITH YOUR PJRCHASES YOU MAY EARN POINTS/CREDITS REDEEMABLE FOR CERTAIN GOODS OR 3ERVICES, Iq ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEI T BY REDEMPTION )F YOUR EARNED POINTS/CREDITS, YOU ARE RE"EIVING OR WILL RECE VE ITOTICE OF T DISCOUNT VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORIS. MERCHANDI! E TOTAL 431.50 nvoice Date + 30 days 431.50 BILL To SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY r_RWFKM1�KEY B-Backordered:Item will follow SK-School Kit 1 1 3.08571 1 6731112-01 431 .50 1) Discontinued:Item no longer available NC-No Charge F-Special Schein Free Goods ... ORDER# :ORDER DATE I-NV OICE DATE # OF BOXES M-Manufacturer will ship Item directly to you P prescription Drug:Return Authorization Required 16520063 02/17/14 2/17/14 S R Refrigerated Item:May be shipped separately $ Special Schein pricing CUSTOMER PQ# PAGE# T Taxable Item Temporarily unavailable:please reorder TOM SMALL 2/17 1 OF 2 Item has MSDS Continued on Next Page.......... AVHENRYSCHEIN' CARSSHIP TO/SOLD TO: 135 I ®� � Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 540 W 136th St Station 46 Michael Kaufmann Carmel,IN 46032-8806 010000130857106731,112110010000000431500217140 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032-7543 Carmel Fire Dept BILLSHIP TO INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032-7543 [�13085�711817102 431.50 INVOICE INVOICE DATE 6731112-01 2/17/14 CUSTOMER PO TOM SMALL 2/17 Please detach here and mail the above with your payment ORDER ORDER DATE DUE 16520063 02/17/14 03/19/14 D&B#:01-243-0880 WHSE DEA# RH0162494 Fed ID: 1 1-3136595 WE s a x- � r: aha r r ✓Will' _: I... .: "".,;,x.»s ..� ,�1�...<�✓/, ;? `r -s at` e...5 � � .: s is Please remi payments only to the following a dress: enry Schein, Inc. ept CH 102 1 Palatine, I 60055-0241 BiI.D To SHIP TO: rivoi E� - - ��. Ixvol E n.MD ITEM STATUS KEY MREMKEY1308571 1817102 6731112-O 1 4 31.5 0 B Backordered:Item will follow D Discontinued;Item no longer available RDER ORDER DATE .INV O I DATE OF BOXES F -Special Schein Free Goods M Manufacturer will ship Item directly to you P Prescription Drug:Return Authorization Required 16520063 02/17/14 2/17/14 5 R -Refrigerated Item:May be shipped separately 7dUSTOMJER--PO PA E $ -Special Schein Pricing T-Taxable Item TOM SMALL 2 17U-Temporarily unavailable:please reorder / 2 OF 2 Rem has MSDS HENRYrA H � 33 16 EMSM� _€w....e£.,...�._.. _••t_ .... �.. �row: .i.. _.....v.•.•:.. -a.r'f me •&'e; :s We,make>,;ere rff=. 't;: aint<i Price s to the duration of a Payment by HE or by the HENRY S HEI CREDIT CARD, cdtal0g,10 never, .e resertiie ti e right t0 make e rice adjustments VISA,MASTERCARD.DIS V ' and AMERICAN EXPRESS response to manufact€rers'price ct€anges Guaranteed Satisfaction: or vrsA If ou have tr ed a Product and it is defec'ive or doesnot of Perfo°3 Bi. 31::3 0r u,r r 0 Wiz.€, .ACC. €iE11, satisfactorily,we will Prov de a credit,refu-d,or exchange;it's jo€r Avai:able t0 licensed prat tit.t r.er.. r t..e U. .A. invoices tees are choice. Simply call our custorncr service deParlment 4hin 30 days a;.abr,,5lithir:.'?v days, 0:r::ceiPt of the rneroha alis.to arrange for th a return. Fora warranty repair or if you;-;ere sent something yo;a did not Order, smiplycall: x Products & Controlled Substances: latrx Medical 1-800-845-3050 Regulations require us to limit the safe of Rx and controlled substances oniy t0 registered;licensed healthcare professionals. l-you are a nein customer or have recentiv moved,Please fur€ sn us with a copy of your updated state registration. For controlled substances,furnish a cops{of tour DEA certificate,verifying your shipping address. Mass 11 drugs can be ordered only b-mail. International Orders: Please Note. We proudly serve healt^c re Pr fess€cnalsand governmentsCpened handpieces and equipment may not be returned for � ,. throughout the world. -o:: 0ace v.ders or r =qu r es a expo t credit;but k„will be repaired d cr replaced in accordance faith terms and cor dit ons;Please contact our International Department: manut«cturer warrant es.Pefcre opening handpieces or 800 X345 35ru eoc;ipme nt,we s agg.st that,;ou check the shipping;ontainer and Packing list t0 ver fy t"<°you:':ave recel,Ve{ exactly;what you crdered.0pened Computer Software Is not returnable. Prescription Drug Returns Instructions: Qther restrictions may also apply. A Return Authorization is Required for all Prescription Drugs,S mply call our"ustomer Service Department --1-300.815-355;1, -. � �� ,'"-� - �.� � •"�� 2 «�� "`� �� ..--:r"”` ..�a;3"'•� �...E.F�,, r.£_ t� �.`` .�y . y3°� y:: s�i' j ��& is �•r �� f&j �� &� g��t �' '3� ee. � � s i�E at�ri�� ' 3 �� F ,� t �x � ��r P3H '`�„3, A l�� •.a�-�€:; �r` � 1 �e.�„�`• l� �� ,, � ��,�;��1��' €3. �� -€'ter" ...._;,.z�...Jmac_...�••..�.�....�....,..,_w.nr_;>._..............____..w... »•,,._._.._...,.._....,,•�, ,..,s, .„_.,_,w:.3.s._„�,,._;...,•.,..._.,....,�....�.a •,•,•.��,.,.,F� ,».,»„•__ „•.•. ...w.,..•.,,..w_�,_..�..._._ LP300 VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 $431.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 6731112-01 1102-390.11 I $431.50 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except MAR 10 2014 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund )rescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL an invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by Nhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 6731112-01 $431.50 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer