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Home My WebLink About237636 09/30/14 9'�/ � CITY OF CARMEL, INDIANA VENDOR: 357526 j ® t'I ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*****1,707.80* r, _�; CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 237636 '.y«oN�. PALATINE IL 60055-0241 CHECK DATE: 09/30/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 1298880-01 743.25 SPECIAL DEPT SUPPLIES 102 4239011 5301635-01 964.55 SPECIAL DEPT SUPPLIES ORDER# ORDER DATE QUE DATE 22496085 09/15/14 10/15/14 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 i f <. 411 F.., w u a $ a his order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 OM 091514 17-571-260 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- 1 890-6868 3/PK LIFEPAK 12 PAPER EKG 10 10 10.65 106.50 3 2 602-8100 EA COLLAR STIFNECK SELECT ADULT 50 50 C 5.50 275.00 1 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 220-1652 EA COLLAR STIFNECK SELECT PEDI 25 25 5.50 137.50 3 4 499-0581 EA SHARP-TRAP BIO-DISP CONTAIN 50 50 1.61 80.50 3 5 220-1398 3/ST BODY STRAP SET DISP YELLOW 25 25 5.75 143.75 3 ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSIJRES/TEZMS OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 743.25 invoice Date + 30 days 743.25 Please remi payments only to the following address: Henry Schei , Inc. Dept CH 10211 alatine, I 60055-0241 BILL TO SHTP TO INVOTCE# INVOICE AMOUNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1617102 1298880-01 743.25 D-Discontinued;Item no longer available NC-No Charge R RDE- AE -ATE- - BOXES P-Special Schein Free Goods M-Manufacturer will ship Item directly to you P-Prescription Drug;Return Authorization Required 22496085 09/15/14 9/15/14 3 R-Refrigerated Item;May be shipped separately TOMER PO P GE $ -Special Schein Pricing T-Taxable Item U-Temporarily unavailable;please reorder TOM 091514 1 OF 1 • -Item has MSDS LP300 rccr�mr�nzcrmrznrr.- poirds/credits 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 cheek the shipping container and packing list to DELIVERY TERMS: ensure that you are getting exactly wliat you ordered.Equipment must be returned Unless otherwise agreed,freight terms are FOB Shipper's Dock t'Ex Works'outside in the original unopened packaging,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.At equipment returns are subject to a restocking fee. 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 incudes 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 additionaf freight charges. Presg ption Drug 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 Heng Schein has purrhased 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 apF)ly,except when special services are requested. Rx Drugs vvhic�h are purchased bi,Henry Schein directly from the manufacturer may Low-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-day air. 1 Only returns due to error in order or delivery will be allowed. Guam.Puerto Riro,U.S.Trust Territories&Virgin Islands: 2 Returns of Poe Drugs will only be accepted if HSI is notified within 14c "' end a ' 4calendar days • All orders vrill be subjeca to a handling charge.l his charge includes freighlthrough of receipt 0f the shipment and valid return authorization is issued by HSI. the United States Postal Service(USPS). 3)The Prescription Drug h4arketing Art requires arty customer returning fix Drur s • Special deaivery orders aril hazardous material shipments can be shipped via United to complete and return a Prescription Drug Return Authorization form.Federalaw Parcel Services(UPS)for an additional charge.No minimum order amount orweight requires that the healtl[ are entity returning Rx Drugs document Shat 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 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 henrysrheiii.cam.Unless otherwise agreed, Rx Drugs certifies Ire ight terms are FOB Shipper's Dock("Ex Works"outside North America). that the product being returned is the same exact product purchased from HSI. True 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 METHO.Q .-- — Regulations require us to limit the sale of Rx acid 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,calf:1.866.398.9296 or online please furnish us with a copy of your updated stale DEA registration.For controlled wivw.hen sclnein.conn/creditcard Reduce the cast and administration of m substances,furnish a copy of your DEA registration veiftrig your shipping.address. rY paying Please nate:that all orders for controller)substances are subject to a due:diligence review Henry Schein-Pay electronically(ACH Debit)or set up AutoPay. process.Schedule II controller)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 wwRv.henrvschein.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 II controlled substances,please mail the farm 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 to use or installation of certain products. terms of sale. Be sure to understand and comphi with arry such requirements prior to purchase,use, Open Accounts Receivable: or installation of products. All unpaid accounts receivable past due,are,subject t0 a 1 51,�.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-_9)m,et. Customer Service: 1.877.344.3402 8:30am-5:30pm,et. Customer Service: 1.800.845.3550 8:30anh-5:30pin,et Place an Order: 1.800.772.4346 8anr Spm,et. Place an Order. 1.877.344.3402 8:30am-5:30pni,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.henryschein.com/medical E-Commerce Support: 1.800.711.6032 8am-bpm,et. Internet: www.lienrVschein.com/erns E-Mail: cusiseru@henryschein.com Internet: wvAv.henryschein.com/340B E-Mail: scott.b runer@h enryschei u.cum E-Mail: customer.support@henryschein.com Please see:littp://vnuw.Henryschein.com,NS-EN,'Medical/LegalTerms.ASPX for Conditions&Exceptions. ORDER# ORDER DATE IDUE DATE 1 22619569 09/18/14 10/18/14 D&134:01-243-0880 WHSEDEA# RHO162494 Fed ID:11-3136595 ra T, 2% RM MI m NN This order has been processed by our MIDWEST D.C. 5315 WES" 74TH 3TREET INDIANAPOLIS,IN 46268 TOM 091814 1 499-5080 EA STYLET W/DISTAL TIP 14FR 20 20 1.50 30.00 11 2 499-7064 EA STYLET W/DISTAL TIP 10FR 10 10 1.50 15.00 11 3 499-3907 EA BLOOD PRESSURE KIT 3 CUFF 1 1 59.55 59.55 11 4 107-0540 90/BX PURPLE NITRILE PF GLOVE X-LARGE 50 50 *C 8.60 430.00 5 CASE GOOD IrEM, MAY BE SHIPPED SEPARATELY. 5 107-0502 100/BX PURPLE NITRILE PF GLOVE MEDIUM 50 50 *C 8.60 430.00 10 :!ASE GOOD ICEM, MAY BE SHIPPED SEPARATELY. PLEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSJRES/TE ZMS OF SALE MERCHANDI ;E TOTAL 964.55 Invoice Date + 30 days 964.55 Please remi- payments only to the following aldress: Henry Scheii, Inc. Dept CH 10211 Palatine, I 60055-0241 BILL To- sHip To INVOICE INVOICE AMOUNT ITEM STATUS KEY M EY B-Backordered;Item will follow _ FM 1308571 1817102 5301635-01 964.55 :K I gl�,In.I ,7 D-Discontinued;Item no longer available N Charge ORDER# ORDER ATE F-Special Schein Free Goods NV # OF BOYES M-Manufacturer will ship Item directly to you P Prescription Drug;Return Authorization Required 22619569 09/18/14 9/18/14 11 R Refrigerated Item;May be shipped separately $ Special Schein Pricing CUSTOMER PO — PAGE# T-Taxable Item U-Temporarily unavailable;please reorder TOM 091814 1 OF Atern has MSDS LP300 (e.g.points,discourdredemptionsor other special awards),with your purchases you mayearn •ItemsfiatcannotLiereturnedtothemanutacturer*Anyitemmarkednometu enable points/credits redeemable for certain goods or services,in accordance with discount program Equipment: rules.Upon discount receipt by redemption of your earned polnts/credits,you are receiving or Opened and used equipment ma not be returned for credit.Before o coin will receive notice of the discount value.Accordingly,you should retain these records. P; y P equipment,we suggest that you check the shipping container and packing list to DELIVERY TERMS: ensure that you are getting exactly what you ordared.Egmpment must be rrturnetl Unless otherwise a reed,freight terms are FOB Shipper's Dock(Ex Vhrorks'outside in the original unopened packaging,unmarked and properly packaged.Speical order North America).Titre passes at the time the shipment is loaded at the shipper's dock. equipment r5 not returnable.At r equipment returns are subject to a restorbng fee. Equipment is backed by the mancifac:turer'S repair or replacement warranhr.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 ne;v equipment.Open or defective egriipment is subject to the manufacturers additional carrier charges related to special delivery seivices and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Drug Returns: Alaska,Hawaii&Pacific Protectorates: Please note that,in order to comply with Federal and State Pedigree requirements, Standard shipping metiiods,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 fix Drugs which Hen ryry 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 WH. 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 be returned providing that the following key elements are met: 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 it HSI is notified within 14 calendar days • All orders grill be subject to a handling charge.]his 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 Act 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.Federa)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 Representative for details. was kept under proper storage and handling conditions while in their possession and during the return at the product.To get a copy of the form and proper return Outside U.S.(50 states): authorization,please contact Customer Service. It your order is beinshipped outside the U.S.(50 states),please refer to the 4)In addition,Pedigree regulations require that the healthcare entity returning International Terms I Conditions at henn.1schein.cont.Unless otherwise agreed, rix 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. --Rn RRO€)UCl'S-«CONTROLLED StlSST/;NGES; - -- --CFIOOS�YOUR P-�lYNlENT-IUIETkIC1D— _- _ Regulations require us to limit the sale of Rx and controlled substances only to registered, 21%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:1.666.396.9296 or online please fumish us with a copy of your updated state DFA registration.For controlled www.henryschein.coni/creditcard Reduce the cost and administration of paying substances,furnish a copy of your DEA registration verifying your shippin'address. Henrychein-Pa electronically ACH Debit or set AutoPa Please note that all orders for controlled substances are subject to a due diligence review N Y y( } up Y process.Schedule II controlled substances ran 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 www.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 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 West74th 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 Local 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 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 retum,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 0:30am-5:30prn,el. Customer Service: 1.800.845.3550 3:30aun-5:30pin,et Place an Order: 1.800.772.4346 Banr-9pni,et. Place an Order. 1.877.344.3402 8:30am-5:301)nt,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. 1.868.665.2253 24 Hours. Fax an Order. 1.600.533.4793 24 Hours. Internet: %vmv.henryschein.com/medical E-Commerce Support: 1.800.711.6032 8am-bpm,et. Internet: www.henrysdiein.com/encs E-Mail: custsery@henryschein.corn Internet: iwrw.henryschein.comJ340B E-Mail: scott.brunerOhearyschein.com E-Mail: customer.support@henMehein.com Please see:littp-/,kvi"v.Henryschein.com/US-EN/Medical/LegalTerms.ASPX for Conditions&Exceptions. VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 $1,707.80 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1120 1298880-01 102-390.11 $743.25 1 hereby certify that the attached invoice(s), or 1120 5301635-01 102-390.11 $964.55 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 SEP 2 9 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 n 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)) 1298880-01 $743.25 5301635-01 $964.55 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