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Home My WebLink About235867 08/13/14 W.��q J• f. CITY OF CARMEL, INDIANA VENDOR: 357526 A■M%MAR'. ® ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $ 30.00 s. =a CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 235867 vyl,, lam: PALATINE IL 60055-0241 CHECK DATE: 08/13/14 [TOl1�� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 3058016-01 30.00 SPECIAL DEPT SUPPLIES Please detach here and mail the above with your payment ORDER# ORDER DATE DUE DATE 21199449 07/28/14 08/27/14 D&B#:01-243-0880 WHSE DEA# RH0162494 Fed ID:11-3136595 gemv o his order has been processed by our MIDWEST D.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 OM SMALL 31.7-571-2600 ---------- --------------------------------- ------ ----- ------------- ------- 1 153-6648 100/BX BIOHAZARD BAG 23X23 RED 231IX23" 2 2 11.00 22.00 1 2 153-2007 20/RL BIOHAZARD BAG 14.5X19 RED 3GAL 4 4 2.00 8.00 1 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSJRES/TEZMS OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 30.00 invoice Date + 30 days 30.00 lease remi payments only to the following a dress: Henry Schei , Inc. Dept CH 10211 Palatine, I 60055-0241 BILL To SHIP TO INVOICEffI E AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 B-Backordered;Item will follow SK-School Kit 3 0 5 8 016-01 3 0•0 0 D-Discontinued;Item no longer available NC-No Charge ORDER# ORDER DATE INVOTCE DATE # OF BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you 2 8 14 7/28/14 P-Prescription Drug;Return Authorization Required 21199449 0 7 / / 1 R-Refrigerated Item;May be shipped separately $ -Special Schein Pricing ER P P E T-Taxable Item U-Temporarily unavailable;please reorder TOM SMALL 1 OF 1 '-Item has MSDS LP m .BOGdl-e}+diIIGlpdilnyInap+uawuoim1U119aPIU5411 (e.g.points,discount redemptions or 011ier special awards),with your purchases you may earn Items that cannot be returned to the manufacturer•Any item marked nonretu rnable poirds/credits redeemable for certain goods or services,in accordance with discount program Erauirhment: rules.Upon discount receipt by redemption of your earned points/credits,you are receiving or 01 ed used equipment may not he returned for credit.Before opening will receive notice of the discount value.Accordingly,you should retain these records. equipment,vie suggest that you check tie shipping container and packing list to DELIVERYTERMS: .ensure that you are getting exactly what you ordered.Equipment must be returned Unless otherwise aggreed,freight terms are FOB Shipper's Dock('Ex Works"outside in tie original unopened ppackaging,unmarked and properly packaged.Speical order North America).Tice passes at the:time the shipment.is loaded at tie shipper's dock. ?quipment is not returnable.All 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 warrarit.,information required immediately upontaking delivery of All orders will be subject to a handling charge.This charge includes freight,exceptfor your new equipment.Open or defective equipment is subject io the manufacturers additional carrier charges related to special delivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Dri.ia 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 Henry 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 Henri Schein has purchased from wholesalers are riot returnable. are offered direct surface transport,or postal services for reliable deliver'. These items will bei 1entified in your invoice with the code WH. No additional surcharges apply,except vihen special services are requested. Rx Drugs which are purchased liv Henry Schein directly from the manufacturer may Low-level hazardous items(dangerous goods in accepted quantities and Consumer be returned providing thatthe following key elements are met: Commodity ID 8000)are now available via LIPS 2nd-day air. 1 Only returns due to error in order or delivery will be allowed. Guam Puerto Rico U.S.Trust Territories&Virgin Islands: 2)Returns of Rx Drugs will only be accepted if HSI is notified within 14 calendar days • All orders vrill be subject to a handling charge. this charge includes freightthrough of receipt of tie shipment and valid return authorization is issued by HSI. the United States Postal Service(USPS). 3)The Prescription Drug Marketing Act 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 gel a copy of tie form and proper return Outside U.S.(50 states): authorization,please contact Customer Service. iIf your order is beingshipped outside tie U.S.(50 states),please refer to the 4)In addition,Pedigree regulations require that the healthcare entity returning- nternational Terms&Conditions at henrrschein.com.Unless otherwise agreed, Rx Drugs certifies "(,Ilitterms are FOB Shipper's Dock("Ex Works"outside North America)• that the product being returned is the.same exact product purchased from HSI. Trte 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 _ Customer is responsible for 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: CHOOSE YOUR PAYMENT-METHOD—- - Regulations require us to limit tie 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,call:1.866.398.9296 or online please furnish us with a copy of your updated state DEA registration.For controlled www.henryscliein.coiii/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 subjeetto a due:diligence review please call Customer Smites for details. process.Schedule II controlled substances ran be ordered electronically or by mail. For information on our Controlled Substance Ordering System please visit For your convenience,we provide several payment alternatives.Orders bilked to your %N"v.henryschein.com/e2.22;if you prefer to continue using Federal 222 Forms to order account may be paid by ACH Debit,Check by Phone,or Check.If you prefer. Schedule 11 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 vihen placing your order.Ail sales are subject to our normal terms and REGULATORY REQUIREMENT: condifions.All sales are subject to credit approval.Invoices are payable within agreed Local regulatory requirements may apply to use or installation of certain products. terms of sake. Be sure to understand and comply with arts 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 8am-9pm,et. Customer Service: 1.877.344.3402 8:30ani-5:30pm,et. Customer Service: 1.800.845.3550 8:30arn-5:30pin,et Place an Order: 1.800.772.4346 8anh-9pm,et. Place an Order: 1.877.344.3402 8:30am-5:301)nh,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. 1.688.885.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: wmv.henryschein.com/medical E-Commerce Support: 1.800.711.6032 Sam-Spm,et. Internet: www.henryschein.conifenis E-Mail: custsery@henryschein.com Internet: >,wrw.henryschein.com/3406 E-Mail: scott.bruner@�henryschein.com E-Mail: custoniecsupportghenryschein.corn Please see:littp:/(wunv.Henryschein.comq)S-EN/Medical/Lega[Terms.ASPXfor Conditions&Exceptions. i VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF$ Dept Ch 10241 Palatine, IL 60055 $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 3058016-01 102-390.11 $30.00 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 AUG 1 w ��14 ffW--0VI 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)) 3058016-01 $30.00 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