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Home My WebLink About235114 07/22/14 q��'��p'\�. CITY OF CARMEL, INDIANA VENDOR: 357526 y �) ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*****"271.00• �. ,_� CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 235114 +,y- � PALATINE IL 60055-0241 CHECK DATE: 07/22/14 �roN�°' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 604125-02 98.00 SPECIAL DEPT SUPPLIES 102 4239011 604668-01 173.00 SPECIAL DEPT SUPPLIES _ _ ._ __ _ -u -Q -u�. - . .,_----- ORDER# ORDER DATE DUE DATE 20630349 07/07/14 08/08/14 D&B#:01-243-0880 WHSE DEA# PG0229321 Fed ID:11-3136595 wis «. o 3t , his order ias been'processed by our GIV D.C. 80 SUMMI VIEW LANE BASTIAN VA 243 4 OHN 317-407-6747 ALVERSON@C URMEL.IN.GOV ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- 1 700-0017 EA LSU NIMH BATTERY 1 1 • 98.00 98.00 1 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFE TO BACK OF PAPERWORK FOR DISCLOS RES/TE S OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 98.00 nvoice Date + 30 days 98.00 lease remi payments only to the following a dress: Henry Schei , Inc. Dept CH 10211 Palatine, I 60055-0241 BTLL TO SHIP T E AMOUNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1308572 604125-02 98.00 D-Discontinued;Item no longer available NC-No Charge RDE RDE DATE INV I E DATE F BOXES F-Special Schein Flee Goods M-Manufacturer will ghip Item directly to you P-Prescription Drug;Return Authorization Required 20630349 07/07/14 7/09/14 1 R-Refrigerated Item;May be shipped separately $ -Special Schein Pricing CUSTOMER PO# PAGE T-Taxable Item JOHN 070714 1 OF 1 U-Temporarily unavailable;please reorder +-Item has MSDS LP300 (e-g.points,discount redemptions or other sped at awards),with your purchases yeu may earn •Items that cannot be returned to the manufacturer•Any Item ma et nome urna e points/credits redeemable for certain goods or services,in accordance with discount program EauiD rules.Upon discount receipt by redemption of your earned points/credits,you are ment: receiving or Equip will receive notice of the discount value.Accordingly,you should retain these records. Opened and used equipment may not be returned for credit.Before Opening equipment,we suggest that you check the shipping container and packing list to DELIVERY TERMS: ensure that you are getting exactly what you ordered.Equipment must be returned Unless otherwise agreed,freight terms are FOB Shipper's Dock("Fx Works'outside in the original unopened packaging,unmarked and properly packaged.Speical order North America).Tine passes at the time the shipment is loaded at the shipper's dock. equipment is riot returnable.Air equipment returns are subject to a restocking fee. Efluiprirentis barked by the manufacturer's repair or replacement warrant;.Please Continental U.S.: read and return all warranh information required immediately upon taking delivery of All orders will be subject to a handling charge.This charge includes freight,erceptfor your new equipment.Open or defective equipment is subject to the manufacturers additional carrier charges related to special delivery services and hazardous material warranty. shipments.Special orders are subject to additionaf freight charges. Prescription Dnig Returns: Alaska.Hawaii&Pacific Protectorates: Please note that,in order to comply with Federal and State Pedigree requirements, Standard shipping methods provide direct,reduced cost,expedited air delivery I lenry Schein's policy on the return of Rx Drugs is as follows: service to all accounts in Alaska and Hawaii.Customers in the Pacific Protectorates Rx Drugs which Heng Schein has purchased from wholesalers are riot returnable. are offered direct surface transport,or postal services for reliable delivery. These items will be identified in your invoice with the code WH. No additional surcharges apply,except when special services are requested. Rx Drugs yvliidi are;purchased by Henry Schein directly from the manufacturer ma,tic Low-level hazardous items(dangerous goods in accepted quantities and Consumer be returned providing that the following key elements are mei: Commodity ID 8000)are now available via UPS 2nd-der,air. 1)Only returns clue to error in order or delivef�y will be.allowed. Guam Puerto Rico 11 S.Trust Territories&Virgin Islands: 2)Returns of Rx Drugs will only be accepted if HSI is notified within 14 calendar days • All orders will be subject to a handling charge.this charge includes treightthrough of receipt of the shipment and valid return authorization is issued by HSI. the United States Postal Service(USPS). 3)The Prescription Drug Marketing Art requires any customer returning Fix Drugs • Special delivery orders and hazardous material shipments can be shipped via United to complete and return a Prescription Drug Return Authorization form.Federal law Parcel Services(UPS)for an additional charge.No minimum order amount or weight requires that the healthcare entity returning Rx Drugs document that the product applies.Speak to your International Representative for details. was kept under proper storage and handling conditions while in their possession and during the return of the product.To get a copy of the form and proper return Outside U.S.(50 states): authorization,please contact Customer Service:. If your order is beingshipped outside the U.S.(50 states);please refer to the 4)In addition,Pedigree regulations require:that Vie healthcare.entity returning International Terms&Conditions at henn,yschein.com.Unless otherwise agreed, Rx Drugs cerfifies freight terms arc,FOB Shipper's Dock(Ex Works"outside North America)• that the product being returned is the same exact product purchased from HSI. Title passes at the time the shipment is loaded at the shipper's dock. 5)Henry Schein will not issue credit for any returned Rx Drugs which have been Custorner is responsible[of compliance with any applicable import requirements. tampered with,are out of date or where the labeling has been altered in any way. RX PRODUCTS & CONTROLLED SUBSTANCES. 0140-6 EYC9UR-PAYNIENT-METHOD" — — — — — --- Regulations require us to limitthe sale of Rx and controlled substances only to registered, 2%Cash Back or Maximum Rewards on all purchases with the Henry Schein licensed healthcare professionals.If you are a new customer or have recently moved, Credit Card.To apply now,Gall:1.666.398.9296 or online please furnish us with a copy of your updated stale DEA registration.For controlled wtvw.henrysclieiii.com/creditcard Reduce the cost and administration of paying substances,furnish a copy of your DEA registration verifying your shipping address. Henry Schein-Pay electronically(ACH Debit)or set up AutoPay. Please note that all orders for controlled substances are subject to a due diligence review process.Schedule I I controlled substances can be ordered electronically or by mail. Please call Customer Service for details. For information on our Controlled Substance Ordering System please visit For your convenience,we provide several payment alternatives.Orders billed to your wv%v.henrysrhein.com/e222;if you preferto continue using Federal 222 Forms to order account may be paid by ACH Debit,Check by Phone,or Check.If you prefer, Schedule II controlled substances,please mail the form to: you may useyour Henry Schein Credit Card,American Express,Visa,MasterCard or Henry Schein,Inc.• Suite 300;5315 West 74th Street • Indianapolis,IN 46268 Discover Card when placing your order.All sales are subject to our normal terms and REGULATORY REQUIREMENT: c:onditions.All sales are subject to credit approval.Invoices are payable within agreed Loral regulatory requirements may apply to use or installation of certain products. terms of sale. Be sure to understand and comply with any such requirements prior to purchase,use Open en Accounts Receivable: or installation of products. All unpaid accounts receivable past ducare subject to a 1.50%finance charge. To arrange for a product return,simply call Customer Service as noted below: Henry Schein Medical 3408 Program Henry Schein Medfcal/EMS Customer Service: 1.800.472.4346 8ain-9;)m,et. Customer Service: 1.877.344.3402 8:30am-5:30pm,el. Customer Service: 1.800.845.3550 8:30ann-5:30pin,et Place an Order: 1.800.772.4346 8anr9pm,et. Place an Order. 1.677.344.3402 8:30am-5:30pm,et. Place an Order. 1.800.845.3550 8:30am-5:30pm,et Fax an Order. 1.800.329.9109 24 Hours. Fax an Order. 1.888.885.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: www.hemyschein.com/medical E-Commerce Support: 1.800.711.6032 Sam—bpm,et. Internet: www.henryscbein.cornlents E-Mail: custsery@henrysehein.com Intemet: www.henryschein.comr340B E-Mail: scott.bruner@henryschein.com E-Mail: etistonier.stipport@henryschein.com Please see:hit : tvtv.Henr schein.com S-EN/Medical/Le aiTerms.ASPX for Conditions&Exceptions. P Ilw y N 9 QRDER# I ORDER DATE IQUE DATE 20631378 07/07/14 08/06/14 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 w r o s %i�o,;u a � ► o a his order has been processed by our MIDWEST D.C. 5315 WEST 74TH 3TREET 7 INDIANAP LIS,IN 46268 OHN 317-407-3747 ALVERSON@C EL.IN.GOV O JOHN 070714 1 153-6483 RX 250ML/BT STERILE WATER FOR IRRIG 250ML 24 B 0.00 0.00 - PEDIGR E ITEM. TEM BACK OZDERED, WILL FOLLOW SHORTLY C:0033800 402 2 107-0502 100/BX PURPLE NITRILE PF GLOVE MEDIUM 20 20 *C 8.65 173.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOS ES/TE S OF SALE - HENRY 3CHEIN, INC. HAS PURCHASED THE SPE IFIL UNIT OF THE PRESCRIPT ON DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 173.00 Invoice Date + 30 days 173.00 lease remi payments only to the following address: enry Schein, Inc. ept CH 10211 alatine, IL 60055-0241 BTLL TO SHTP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1817102 604668-01 173 .00 D-Discontinued;Item no longer available NC-No Charge RDER DE A INVOICE DATE F BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you P-Prescription Drug;Return Authorization Required 20631378 07/07/14 7/07/14 2 R-Refrigerated Item;May be shipped separately $ -Special Schein Pricing CUSTOMERPO# PAGE T-Taxable Item JOHN 0 7 0 714 1 OF 1 U-Temporarily unavailable;please reorder +-Item has MSDS LP300 (e.g.poirds,discount redemptions or other special awards),with your purchases you may earn •Items that cannot be returned to the manufacturer•Any item marked nonreturnable points/credits;redeemable for certain goods or services,in accordance with discount program rules.Upon discount receipt by redemption of your earned pointslcredits,you aro receiving or Equipment: will receive notice of the discount value.Accordingly,you should retain these records. Opened and used equipment may not be returned for credit.Before opening equipment,we suggest that,you check the shipping container and packing Inst to DELIVERY TERMS: ensure that you are getting exactly what you ordered.Equipment must be returned Unless otherwise agreed,freight terms are FOB Shipper's Dock('Ex Works"outside in Vie original unopened packaging,unmarked and properly packaged.Speical order North America).Title passes at the time the shipment is loaded at Vie shipper's dock. equipment is riot returnable.AI equipment returns are subject to a restocking tee. Equipment is backed by the manufacturer's repair or replacement warranty.Please Continental U.S.: read and return all warranty information required immediately upon taking delivery of All orders will be subject to a handling charge.This charge includes freight,except for your new equipment.Open or defective equipment is subject to the manufacturers additional carrier charges related to special delivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Drtrg_Returns: Alaska.Hawaii&Pacific Protectorates: Please note that.in order to comply with Federal and State Pedigree requirements, Standard shipping methods provide direct,reduced cost,expedited air delivery Henn Schein's policy on the return of Fix Drugs is as follows: service to all accounts in Alaska and Hawaii.Customers in the Pacific Protectorates Rx Drugs which Henri Schein has purchased from wholesalers are not returnable. are offered direct surface transport,or postal services for reliable delivery. These items will be identified in your invoice witli the rode WH. No additional surcharges apply,except when special services are requested. Rx Drugs vahich are purchased by Henry Schein directly from the manufacturer may I_ow-level hazardous items(dangerous goods in accepted quantities and Consumer be returned providing that the following key elements are met: Commodity ID 8000)are now available via LIPS 2nd-d,rg air. • 1)Only returns due to error in order or tleliveppr will be allowed. Guam_,Puerto Rico,U.S.Trust Territories&Virrgin Islands: 2)Returns of Rx Drugs will only be accepted if HSI is notified within 14 calendar days • All orders will be subject to it handling charge.This charge includes freight through of receipt of the shipment and valid return authorization is issued by HSI. the United States Postal Service(USPS). 3)The Prescription Drug Marketing Art requires any customer returning Rx Drugs • Special delivery orders and hazardous material shipments can be shipped via United to complete and return a Prescription Drug Return Authorization form.Federal law Parcel Services(UPS)for an additional charge.No minimum order amount or weight requires that the healthcare eaitity returning Rx Drugs document that the product applies.Speak to your International Representative for details. was kept under proper storage and handling conditions while in their possession and during the return of the product.To get a copy of the form and proper return Outside U.S.(50 states authorization,please contact Customer Service. t your order is being shipped outside Vie U.S.(50 states):please refer to the 4)In addition,Pedigree regulations require that tic:healthcare entity returning international Terms&Conditions at hennischein.conh.Unless otherwise agreed, Rx Drugs certifies freight terms are FOB Shipper's Dock("Ex Works"outside North America). that the product being returned is the same exact product purchased from HSI. Tite passes at tie time the shipment is loaded at the shipper's dock. 5)Henn Schein will not issue credit for any returned Rx Drugs which have been Customer is responsible for cornpliance with any applicable import requirements. tampered with,are out of date or where the labeling has been altered in any way. RX PRObUCTS& CONTROLLED SUi3STAiVCES - CHOOSEYOUR PAYMENT-METHOQ - - -- -- — " Regulations require us to limit the sale of Rx and controlled substances only to registered, 20/6 Cash Back or Maximum Rewards on all purchases with the Henry Schein licensed healthcare professionals.If you are a neva customer or have recently moved, Credit Card.To apply now,call:1.666.398.9296 or online please furnish is tvitl a copy of your updated state DFA registration.For controlled www.henryscireiii.cont/creditcard Reduce the cost acid administration of paying substances,furnish a copy of your DEA registration veriitcing your shipping address. Henry ScheirrPay electronically(ACH Debit)or set up AutoPay. Please notethat all orders for controlled substances are subject to a due diligence review process.Schedule II controlled substances can be ordered electronically or by mail. Please call Customer Service for details. For information on our Controlled Substance Ordering System please visit For your corwenience,we provide several payment alternatives.Orders billed to your wwm,.henrysrhein.com/e222;if you preferto continue using Federal 222.Forms to order account may be paid by ACH Debit,Check by Phone,or Check.If you prefer. Schedule II controlled substances,please mail the form to: you may useyour Henry Schein Credit Card,American Express,Visa,MasterCard or Henry Schein,Inc. • Suite 300,5315 West 74th Street • Indianapolis,IN 46268 Disrover Card when placing your order.All sales are subject to our normal terms and REGULATORY REQUIREMENT: conditions.All sales are subject to credit approval.Invoices are payable within agreed Local regulatory requirements may apply l0 use or installation of certain products. terms of sale. Be sure to understand and comply with any such requirements prior to purchase,use, Open Accounts Receivable: or installation of products. All unpaid accounts receivable past due are subject to a 1.5%finance charge. To arrange for a product return,simply call Customer Service as noted below: Henry Schein Medical 3408 Program Henry Schein Medical/EMS Customer Service: 1.800.472.4346 Barrr9pm,et. Customer Service: 1.877.344.3402 8:30am-5:30pin,ot. Customer Service: 1.800.845.3550 8:30am-5:30prn,et Place an Order 1.800.772.4346 8am-9pnh,et. Place an Order. 1.877.344.3402 8:30am-5:301)ni,et. Place an Order. 1.800.845.3550 8:30am-5:30pm,et Fax an Order. 1.800.329.9109 24 Hours. Fax an Order. 1.888.885.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: %vmv.henryschein.com/medical E-Commerce Support: 1.800.711.6032 8am-8pm,et. Internet: www.henryschein.coni/erns E-Mail: cusiseru@henryschein_com Internet: tivvrnv.henryschein.com/3400 E-Mail: scott.bruner@henryschein.com E-Mail: customer.stipport@henryschein.coin Please see:http-Ilmvtv.Henryschein.comJUS-EN/Medical/LegalTerms.ASPX for Conditions&Exceptions. VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF$ Dept Ch 10241 Palatine, IL 60055 $271.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 604668-01 102-390.11 $173.00 1 hereby certify that the attached invoice(s), or 1120 604125-02 102-390.11 $98.00 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 2 1 2014 zz�;& D Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed 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 whom, 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)) 604668-01 $173.00 604125-02 $98.00 I 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