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Home My WebLink About238835 11/05/14 CITY OF CARMEL, INDIANA VENDOR: 357526 CHECKAMOUNT: $********22 22* (9, ONE CIVIC SQUARE HENRY SCHEIN INCCARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 238835 PALATINE IL 60055-0241 CHECK DATE: 11/05/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13983702 22.22 SPECIAL DEPT SUPPLIES Please detach here and mail the above with your payment ORDER# I ORDER DATE IQUE DATE 23565780 10/22/14 1 11/21/14 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 p� 'MR 111 ,' 9 P i� C � p WNW e F his order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- 1 220-8345 100/BX TEMPA-DOT THERMOMETERS STERILE 2 2 11.11 22.22 1 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOS ES/TE S OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 22.22 Invoice Date + 30 days 22.22 lease remi payments only to the following a dress: enry Schei , Inc. Dept CH 10211 Palatine, I 60055-0241 HILL x I I ICE o ITEM STATUS KEY FIK EM KEY B-Backordered:Item will follow -School Kit1308571 1308572 13983702 22•22 D-Discontinued:Item no longer available -No Charge ORDER# ORDER DATE INVOICE DATE it OF BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you P-Prescription Drug;Return Authorization Required 23565780 10/22/14 10/22/14 1 R-Refrigerated Item;May be shipped separately $ -Special Schein Pricing CUSTOMER PO# n PAGE T-Taxable Item U-Temporarily unavailable;please reorder JONATHAN 1 OF 1 "-Item has MSDS LP300 tra eFS rs points,discount redemptions or others special awards with 1eour purchases you m y earn •Items that cannot be returned to the manufacturer•Am item marked nonreturnable dill (e-g.P P P )� Y P Y may l poirdsteredits redeemable for certain goods or services,in accordance with discount program Equipment: miles.Upon discount receipt by redemption of your earned points/credits,you are receiving or E—qT 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 parking list to DELIVERY TERMS' ensure that you are getting exactly what you ordered.Equipment must be returned Unless otherwise ae reed,freight terms are FOB Shipper's Dock('Ex Works"outside. in the original unopened packar�ing,unmarked and properly packaged.Speical order North America).Tie passes at the time the shipment is loaded at Ute shipper's dock. equipment is not returnabble.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 includes freight,exceptfor your new equipment.Open or defective equipment is subject to the manufacturers cial additional carrier charges related to spedelivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Dray Returns: Alaska.Hawaii&Pacific Protectorates: Please note that;in order F0 romply with Federal and State:Pedigree requirements, Standard shipping methods provide direct,reduced cost;expedited air delivery Henri 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 Henrry 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 rode WH. No additional surcharges apply,except when special services are requested. Rx Drugs which are purchased 61,1 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 UPS 2nd-day air. 1 Only returns due to error in order or deliver}1 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.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 Act requires arty 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 Serices(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 the form and proper return Outside U.S.(50 states): authorization,please contact Customer Service. It your order is being shipped outside Ute U.S.(50 states),please refer to the 4)In addition,Pedigree regulations require that tile:healthcare entity,returning International 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 hasbeen altered in any way. RX PRODUCTS &CONTROLLED SUBSTANCES: CHOOSEYOUR PAYMENT—METHOD— Regulations AYMENTMETHODRegulations require us to limit the sale of Rx and controlled substances only to registered, 29%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:1.600.398.9296 or online please furnish us with a copy otiynur updated state DEA.registration.For controlled www.henryschein.com/crediteard Reduce the cost and administration of paying substances,furnish a copy of your DFA registration verifying}lour 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 controller)substances can be ordered electronically or 6v 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 utititiv.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 If 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 Local 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, Oven Accounts Receivable: or installation of products. All unpaid accounts receivable past due are subject to a 1 finance charge. To arrange for a product return,simply call Customer Service as noted below: Henry Schein Medical 3408 Program Henry Schein Medlcal/EMS Customer Service: 1.800.472.4346 Barn-9pm,at. Customer Service: 1.877.344.3402 6:30ani-5:30prn,at. Customer Service: 1.800.845.3550 3:30arn-5:30prn,et Place an Order: 1.800.772.4346 8am-9pm,at. Place an Order 1.077.344.3402 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 flours. Fax an Order. 1.888.805.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: ►vww.henryschein.com/medical E-Commerce Support: 1.800.711.6032 Sam-bpm,et. Internet: www.henryschein.com/ems E-Mail: custserr@henryschein.com Internet: wvrw.henryschein.com/340B E-Mail: scott.bruner@henryschein.eom E-Mail: customer.support@henryschein.com Please see:http://vnenv.Henryschein.com/lJS-EN,gAedical/LegalTerms.ASPX for Conditions&F_rceptions. I VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF$ - Dept Ch 10241 Palatine, IL 60055 $22.22 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 13983702 102-390.11 $22.22 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 OCT 3 1 2014 1-.7, 7 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund i 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)) 13983702 $22.22 I 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