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Home My WebLink About236403 08/27/14 CITY OF CARMEL, INDIANA VENDOR: 357526 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $********29.50* CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 236403 MtioN�. PALATINE IL 60055-0241 CHECK DATE: 08/27/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 9743326-01 12.50 SPECIAL DEPT SUPPLIES 102 4239011 9745913-01 17.00 SPECIAL DEPT SUPPLIES ORDER - ORDER DATE DUEDATE 21527508 08/08/14 09/07/14 D&B#:01-243-0880 WHSEDEA# RH0162494 Fed ID: 11-3136595 CONTAINS MULTIPLE INVOICES his order has been processed by our MIDWEST D.C. 5315 WES 74TH STREET INDIANAP LIS,IN 46268 1 120-2048 25/PK COMBINE ABD PAD STERILE 5X9 5 5 2.50 12.50 1 LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSJRES/TEZMS OF SALE MERCHANDI E TOTAL 12.50 Invoice Date + 30 days 12.50 lease remi payments only to the following a dress: Henry Schei , Inc. - - Dept CH 10211 Palatine, I 60055-0241 HILL TO SHIP TO - INVOICE _ INVOICE AM UNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1817102 9743326-01 12.5 0 D-Discontinued;Item no longer available NC-No Charge ORDER# 'ORDER- ATE - NV -: ItTE' BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you , 0 8 14 8/08/14 1 P-Prescription Drug;Return Authorization Required 21527508 0 8 / / - R-Refrigerated Item;May be shipped separately S ME PO 1?A E $ -Special Schein Pricing T-Taxable Item JON 080714 1 OF 1 *-Item Temporarily MDS unavailable;please reorder t --1Toms--irral-caTDW1imreitirneuU!fineIlTallU18GlU1ClaHtIyIteIIIIIIdIMAIIIUIItMUlIlaDI pointstcredits redeemable for certain goods or services,in accordance with discount program rules.Upon discount receipt by redemption of your earned points/credits,you are 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 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�'Ex Works"outside in the original unopened packaging,unmarked and properly packaged.Speical order North America).Tile passes at the time the shipment is loaded at the shipper's dock. equipment is riot returnable.Air equipollent returns are subject to a restocking fee. Equipment is barked by the manufacturer's repair or replacement warrant/.Please Continental U.S.: read and return all warrant;,information required immediately upon taking deliver+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 manufacturer s additional carrier charges related to special delivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Dr.g Returns: Alaska.Hawaii&Pacific Protectorates: Please note that,in order to comply vvith Federal and State Pedigree requirements, _Standard shipping methods provide direct,reduced cost,expedited air delivery Henr,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 not returnable. are offered direct surface transport,or postal services for reliable delivery. These items will be identified in your Invoice with the code WIi. No additional surcharges apply,except when special services are requested. Rx Drugs which are purchased by Henry Schein directly from the manufacturer may Low-level hazardous items(dangerous goods In accepted quantities and Consumer tie returned providing that the foflowinq key elements are mrt: Commodity ID 9000)are now,available via UPS 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 will be subject to a handling charge. ][its charge includes freightthrough 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 orweight requires that the healthcare entity returning Rx Drugs document that the product applies.Speak to your International Represaltative for details. was kept under proper storage and handling conditions while.in their possession and during the return of[tie produrt.To get a copy of he form and proper return Outside U.S.(50 states): authorization,please contact Customer Service. If your order is being shipped outside the U.S.(50 states).please refer to the 4)In addition,Pedigree regulations require that the healthcare entity returning International Terms&Conditions at henryschein.coIll.Unless otherwise agreed, Rx Drugs certifies freightterms are FOB Shipper's Dock("Ex Works"outside North America)• that product being returned is the salve exact product purchased from HSI. Tile 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 anyway. -RX PRODUCTS-&-CONTROLLED-SURSTANCES2— - -CHOOSESOUR-PAYM.EI+T-METHOD ----- - — - 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 new customer or have recently moved, Credit Card.To apply now,call;1.866.396.9296 or online please furnish its with a cop;'of your updated state DEA registration.For controlled www.henrysclieiin.com/credReard Reduce the cost acid administration of paying substances,furnish a copy of your DEA registration verifying your shipping address. Henry ScheirrPay electronically(ACH Debit)or set up AutaPay. Please note that all orders for controlled substances arc:subje-ctto a due diligence review process.Schedule II controlled substances c:an 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,the provide several payment alternatives.Orders billed to your www.henrysrhein.com/022.2;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 B 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 46260 Discover 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 Loral regulatory requirements may apply to use or installation of certain products. terms of sale. Be sure to understand and comply,With arry such requirements prior to purchase,use, Open Accounts Receivable: or installation of products. All unpaid amounts 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 340B Program Henry Schein Medical/EMS Customer Service: 1.800.472.4346 Barn-9pm,et. Customer Service: 1.877.344.3402 801m-5:30prn,et. Customer Service: 1.800.&15.3550 8:30am-5:30prn,et Place an Order: 1.800.772.4346 Sam-9pni,et. Place an Order. 1.877.344.3402 8:30am-5:301)m,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 liners. Fax an Order. 1.800.533.4793 24 iiours. Internet: www.henryschein.com/medical E-Commerce Support: 1.800.711.6032 Elam-81)ni,et. Internet: www.hemyschein_cornjems E-Mail: custservghenryschein_com Internet: www.henryschein.com/3406 E-Mail: scott.bruner@hearyschein.cum E-Mail: customer.stipport@henryschein.com Please see:littp:/,www.Henryschein.com/US-EN,'Medical/LegalTerms.ASPX for Conditions&Exceptions. ii LP300 ORDER4 I ORDER DATE- DUE DATE 21527563 08/08/14 09/07/14 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID:11-3136595 his order has been processed by our MIDWEST B.C. 5315 WEST 74TH 3TREET INDIANAP LIS,IN 46268 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- 1 499-5174 EA MEDSOURCE CPR MASK ADULT 4 4 4.25 17.00 1 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSIJRES/TEZMS OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 17.00 Invoice Date + 30 days 17.00 Please remi payments only to the following a dress: Henry Schei Inc. Dept CH 10211 Palatine, I 60055-0241 BILL TO -SHIP TO - -rnvo Ce- - INVOICE AMOUNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1308572 9745913-01 17.0 0 D-Discontinued;Item no longer available NC-No Charge RD - ORDER ATE DA E P BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you 0 8 14 8/08/14 P-Prescription Drug;Return Authorization Required 21527563 0 8 / / 1 R-Refrigerated Item;May be shipped separately - - -.. ... . $ -Special Schein Pricing 'CUSTOMER--PO# PAGE T-Taxable Item JON 080814 1 OF 1 U-Temporarily unavailable;please reorder • -Item has MSDS f5Z1'larl:41-JimuuruullhilltouIL;IIIdilUldULUMI-HllyILGIIIIIId111GUII11111GLU11MUM pointsiciedits redeemable for certain goods or services,in accordance with discount program rules.Upon discount receipt by redemption of your earned points/credits,you are receiving or Equipment: will receive notice of the discount value.Accordingly,you should retain these records. Opened and used equip merit 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 k'Ex Works"outside in the original unopenedpackaging,unmarked and properly packaged.Speical order North America).Title passes at the time:the shipment is loaded at the shipper's dock. equipment is not returnable.Airequipment returns are subfect to a restocking lee. Equipment is backed by the manufacturer's repair or replacement warrant:.Please Continental U.S.: read acid return all wariant;,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 Dn.ig 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 fix Drugs is as follows: service to all accounts in Alaska and Hawaii.Customers in the Pacific Protectorates Rx Drugs which Henry Schein has purchased from wholesalers are not returnable. are offered direct surface transport,or postal services for reliable deliver/. These items will be identified in vour invoice with the rode WH. No additional surcharges apply,except when special services are requested. Rx Drugs which are purchased 6V Henry Schein directly from the manufacturer may Low-level hazardous items(dangerous goods in accepted quantities and Consumer be returned providing that the foflowinq key elements are met: Commodity ID 8000)are now available via UPS 2nd-day air. 1 Only returns due to error in order or delivery will be allowed. Guam.Puerto Rico,U.S.Trust Territories&Vir(hin 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 freightthrotigh of receipt of the shipment and valid return authorization is issued by HSI. the United States Postal Service(USE'S). 3)The Prescription Dniy P�'arketing Art requires any customer returning Fix Drugs • Special rJcaivrry orders and hazardous material shipments can be shipped via United to complete and return a Prescription Urug Return Authorization form.Federal law Parcel Se r fes(UPS)for an additional charge.No minimum order amount orweight 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 Outside U.S. 50 states): and during the return of the product.Ta get a copy of the form and proper return ( authorization,please contort Customer Service. If your order is bein shipped outside the U.S.(50 states),please refer to the 4)In ad(ition,Pedigree regulations require that the healthe:are:entity returning it Terms&Conditions at hennischein.com.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. 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 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. __13)0? CONTROLLED SUBSTANCES: __ C.H4QSEYOURP_AYMEiV_T__MET_HQD_____ fieyolations require us to limit the sale of Rx aril 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 pis with a copy of your updated state UFA registration.For controlled wtvw.henrysclieiii.com/creditcard Reduce the cost and administration ofin substa ,furnish a copy of your DFA registration verih4ng your shipping address. Henry Sche rrPay electronically(ACH Debit)or set up AutoPay. paY g nces Please note that 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 corrrenience,we provide several payment alternatives.Orders billed to your t%mm.henryschein.com/e222;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 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 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, Offen 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 3406 Program Henry Schein Medical/EMS Customer Service: 1.800.472.4346 8am-I.Vm,et. Customer Service: 1.877.344.3402 8:30am-5:30prn,el. Customer Service: 1.800.845.3550 8:30am-5:30pin,et Place an Order 1.800.772.4346 Banr9pni,et. Place an Order. 1.077.344.3402 8:30am-5:30pm,et. Place an Order 1.800.845.3550 8:30am-5:301)m,et. Fax an Order. 1.800.329.9109 24 lieurs. Fax an Order. 1.868.885.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: %wAv.hourVschein.com/medical E-Commerce Support: 1.800.711.6032 Sam-Spm,et. Internet: www.lienrVscliein.com/enis E-Mail: custserv^shenryschein.com Internet: www.henryschein.comr34011 E-Mail: scott.bruner@henryschein.com E-Mail: customer.stipport@henryschein.coin Please see:http://wt"v.Henryschein.com/lfS-EN,'Medical/LegalTerms.ASPX for Conditions&Exreptions. LP300 VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 $29.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1120 9743326-01 102-390.11 $12.50 1 hereby certify that the attached invoice(s), or 1120 9745913-01 102-390.11 $17.00 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 AUG 2 5 2014 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)) 9743326-01 $12.50 9745913-01 $17.00 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