Loading...
HomeMy WebLinkAbout240700 01/07/15 Oi" CITY OF CARMEL, INDIANA VENDOR: 357526 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*****3,470.07* CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 240700 PALATINE IL 60055-0241 CHECK DATE: 01/07/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 15321685 11.16 SPECIAL DEPT SUPPLIES 102 4239011 15529998 89.91 SPECIAL DEPT SUPPLIES 102 4239011 15592931 3,369.00 SPECIAL DEPT SUPPLIES ORDER# ORDER DATE I IDUE DATE 25039514 12/16/14 01/15/15 D&B#:01-243-0880 WHSEDEA# RHO162494 Fed ID: H-3136595 *'n n rhis order has been processed by our MIDWEST D.C. 5315 WEST 74TH TREET 5.1 INDIANAP)LIS,IN 4627268 ON 317-571-260) 1 644-3135 5/BX QUIKCLOT 25GM 1 1 31.95 31.95 1 2 499-7818 EA COMBAT TOURNIQUET- BLK 1 1 24.04 24.04 1 3 499-6698 EA THE POCKET BVM 1 1 33.92 33,92 2 rHIS PRODUC IS BEING SHIPPED FROM OUR WEST C)AST DI3TRIBU'1ION CENTER. PLEASE REFEZTOBACKOFPAPERWORKFOR DISCLOSJRES/TEZMS OF SALE _ --------------------------------- _ _ _ _ �Iestern Dis:ribution Center 255 VISTA B,VD PARKS, NV 39434 MERCHANDI E TOTAL 89.91 Invoice Date + 30 days 89.91 lease remi-_ payments only to the following aldress: Henry Scheii, Inc. Dept CH 10211 Palatine, 1, 60055-0241 13ILL TO SH12 TO INVOICE# INVOICE AMO= ITEM STATUS KEY FREM KEY B-Backordered:Item will follow SK-School Kit 1308571 1308572 15529998 89.91 D-Disconinued:Item no longer available NC-No Charge F-Specialoffer QRDRR# ORDER DATE INVOICE aATE 4 OF BOXES M-Manufacturer will ship Item directly to you P prescription Dg:Return Authorization Required 25039514 12/16/14 12/16/14 2 R Refrigerated Item:May be shipped separately PO# AGE# $ Special Schein Pricing CUSTOMER T-Taxable Item U-Temporarily unavailable:please reorder JON 1P OF 1 -Item has MSDS LP300 poirdslcreditsredeemable for certain goodsorservices,in accordance with discount program rales.Upon discount receipt by redemption of your earned points/credits,you are rete:....,or Equipment: will receive notice of the discount value.Accordingly,you should retain these records. Opened and used equipment(nay not be returned for credit.Betme 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 Duck('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 riot returnable.Alrequiprnent returns are subject to a restocking fee. Equipment is barked 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 nen equipment.Opcm 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 Drug_Returns: Alaska.Hawaii&Pacific Prnle.ctorates: Please note that.in order to comply with Federal and State Pedigree requireriic:nis, Standard shipping methods provide direct,reduced cost.expedited air delivery Flenry Schein's policy on the,return of Rx Drugs is as follows: service: Hx Drugs to all ac(nunis in Alaska and Flawaii.Customers in the Pacific Protectorates which Henry Schein has purchased from wholesalers are riot returnable. are offered direct surface transport,or postal services for reliable delivery. These nems will be identified in your invoicewith the rode WH. No additional surcharges apply,except when special services are requested. Rx Drugs which are purchased Ly Henry Schein directly from the;manufacturer may Low-level hazardous items(dangerous goods in accepted quantities and Consumer be returned providing that the to(owing key elements are met: Commodity ID 8000)are now available via LIPS 2nd-d,r.,air. 1)Only returns rbre to error in order or delivery will be allowed. Guam Puerto Rico,U.S.Trust Territories&Virx�Islands: 2)Returns of Por Drugs will only be.accepted if HSI is notified within 14 calendar days • All orders vtill be Subject to a 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)Thr;Prescription Drug Marketing Act raquires any customer returning Fix Drugs • Special deliv,,iry orders and hazardous material shipmr;nts can he shipped,,ia 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 oyeight 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.Jo get a copy of the form and proper return Outside U.&(50 slatest: authorizattun,please contact customer Service. ft 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 TF;rms&Conditions at hennlsoheih.con1.Unless utherMse agreed, Hx Drugs certifies freight terms are Fi!B Shipper's Finck("Ex Works"outside North America). that the product being returned is the same exact rr?rodurt purchased.corn 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 Gustoiner is responsible for compliance with any applicable import requirements. tamperer.with,are out of date or where the labeling has been altered in any wly. RX PRODUCTS & CONTROLLED SUBSTANCES: CHOOSEYOUR PAYMENT METHOD Regulations require us to limit the sale of fvc and controlled substances only to registered, 2%Cash Back or Maximum Rewards on all purchases with the Henry Schein licensed healthcare professionals,It you are a neve 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 stale DEA registration.For controlled www.henryschein.com/creditcard Reduce the cost and administration of paying substances,furnish a copy of your DEA registration verifying your shipping address. Please note that all orders for controlled substanco.s arc:subject to a due diligence review Henry Schein—Pay electronically(ACR Debit)or set up AutoPay. process.Schedule It controlled substances can be ordered electrunically 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+.,tiv.henrvschein.(;om/e222:if)lou prefer to continue using Federal 222 Forms to or account may be paid by ACH Debit,Check by Phone,ur Check.If you prefer, Schedule II controlled substances,please mail the torm 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 nisrover hard 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 rnav 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 return,simply call Customer Service as noted below: Henry Schein Medical 3446 Program Henry Schein Medlcal/EMS Customer Service: 1.800.472.4346 Barn—fiprn.ct. Customer Service: 1.877.344.3402 8:30am-5:30prn,el. Customer Service: 1.800.845.3550 3:3£Aim 5:30prn,at. Place an Order: 1.800.772.4346 Bam-9pm,at. Place an Order. 1.877.344.3402 8:30am-5:30pm,at. Place an Order: 1.800.845.3550 8:30am-5:301)m,et. Fax an Order. 1.800.329.9109 24 hours. Fax an Order: 1.888.085.2253 24 Hours. Fax an Order: 1.800.533.4793 24 Hours. Internet: ivww.henn/schein.com/medical E-Commerce Support: 1.800.711.6032 Bam—bpm,at. Internet: www.hemyschein.coni(enis E-Mail: custsery@henryschein.com Internet: www.henryschein.com/3400 E-Mail: scoti.brunerChenryschein.com E-Mail: customecsupportghenryschein.com Please See:Iittp:/)Wwty.Henryschein.com,US-EN/Med.cal/LegaiTerms.ASPX for Conditions&Exceptions. ORDER# ORDER DATE IDUE DATE 24826823 12/09/14 01/08/151 D&B#:01-243-0880 WHSE DEA# RHO 162494 Fed ID: 11-3136595 A rhis order has been processed by our MIDWEST D.C. 5315 WES'" 74TH 3TREET INDIANAP LIS,IN 46268 ON ALVERS04 EMS CAPTAIN CARMEL FIRE DEPARTMENT 2 CIVIC SQURE, CARMEL IN 46032 317-571-260) HEADQUARTERS 17-571-266 7- 1-2C6) FAX ALV:;SON kRMEL.IN.GOV 1 677-9945 EA CYLINDER WRENCH METAL SZ SM 6 6 1.86 11.16 1 PLEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSlJRES/TE ZMS OF SALE MERCHANDI ,E TOTAL 11.16 invoice Date + 30 days 11.16 Please remi payments only to the following aldress: Henry Schei , Inc. Dept CH 10211 Palatine, 1, 60055-0241 BILL TO -SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY r_iRTM�KEY I-Backordered:Item will follow SK-School Kit 1) ) 1308571 1308572 15321685 11.16 Discontinued:Item no longer available NC-No Charge F Special'0fu,0,, ORDER# ORDER DATE INVOICE DATE # OF BOXES M-Manufacturer will ship Item directly to you 11 Prescription Drug:Return Authorization Required 24826823 12/09/14 12/09/14 1 R Refrigerated Item:May he shipped separately $ Special Schein Pricing CUSTOMER P PAGE# T Taxable Item Temporarily unavailable.please reorder JON 1 OF 1 Item has MSDS LP300 pointsicreditsredeemable for certain goodsorservices,in accordance with discount program rales.Upon discount receipt by redemption of your earned points/credits,you are receiving orEquipment: will receive notice of the discourd value.Accordingly,you should retain these records. OpHned anti 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 what you ordered,f quipment must be returned Unless otherwise agreed,freight terms are FOB Shipper's Dock"'Ex Works'outside. in the original unopened j7.ickaging,unmarked and proporly packaged.Speical order North America).Title passes at the time the shipment is loaded of the shipper's clock, equipment is riot returnable.Alrequipment returns are.subject to a restocking lee. Equipment is backed by the manufacturer's repair or replacement warranty.Please Continental U.S.: read and return all warrant;-information required immediately upon taking delivery of All orders will he 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 rotated to special delivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Dntg Returns: Alaska Hawaii$Pacific Protector ales: Phase note that.in order to comply with federal and State Peeiigree requiremants, Standard shipping methods provide direct,reduced cost,expedited air delivery Henn Schein's policy on the return of Rx Drugs is as follows: servico to all accounts in Alaska and I lawaii,Customers in the Pacific Protectorates Rx Drugs which Henry Schein has purrhased from wholesalers are riot returnable. are offered direct surface transport,or postal services for reliable dolivery These items will be identified in your mvoie;e vrifh the rode WH. No additional surcharges apply,except when special services are requested. Rx Drugs which are purchased L;r Henry Schein directly from the manufacturer may [.ow-level hazardous Items(dangerous goods in accepted quantities and Consumer be returned providing that the toflowing key elements are met Commodity ID WOO)are.now available via UPS 2nd-day air. 1 Only returns due to error in order or cieliv("r r will he,allowed. Guam Puerto Rico,U.S.Trust Territories&L'irgin 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 freight through of receipt of[tie shipment and valid return authorization is issued by HSI. [he United States Postal Service(USPS). 3)The Prescription Dont Marketing Act requires any customer returning Fix Drugs • Special delivery niders and hazardous material shipments can he shipped via I Inited to complete and return a Prescription Drug Return Auth0ri7ation form.Federal law Parcel S(,r,ices(UPS)for an additional charge.No minimum order amount orweight requires that the healthcare entity returning Rx Drugs document[hat the product applies.Speak to your International Reptesentatiae tut 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.(550 slates): 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 reraulations require that the healthcare entity returning International Terms&Conditions at henr;rschein.coill.Unless otherwise agreed, Rx Drugs certifies freight terms are FOR Shipper's Dock("Fx Works"outside:North Amerfcal, 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 wits not issue creAlii for any retumed Rx Drugs which have been Customer is responsible(or compliance with any applicable import requirements. tampered with,are out of date or where the labeling has beim aliened in any way. RX PRODUCTS & CONTROLLED SUBSTANCES: CHOOSEYOUR PAYMENT METHOD Regulations rectuiie us to limit the sale ut Rx arid controlled substances only to reilfstered, 21/6 Cash Back or Maximum Rewards on all purchases with the Henry Schein licensed healthcare prolessionals.It you are a new custumer or have re.cently moved, Credit Card.To apply now,call:1.666.396.9296 or online please furnish its"witti a copy of your updated state DEA registration.For controlled www.henryschein.comJcreditcard Reduce the cost and administration of paying substances,furnish a copy of your DEA icgistration vorifyin9 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 II controlled substances can be ordered electronically or by mail. Please call Customer Service for details. For information on our Controlled Substance Ordering System pleasevisit For your convenience,'we.provide saveral payment alternatives.Orders billed to your %vl,,tiv.henrvschein.com/(,222:if lrou prefer to continue using Federal 222 Forms to order account may be paid by ACH Debit,Check by Phone,of Check.If you prefer, Schedule II controlled substances,please mail the form to: you may useyout Henry Schein Credit Gard,American Express;Visa,MasterCard or Henry Schein.Inc. • Suite 300,5315 West 74th Street • Indianapolis,IN 46266 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 sate. Be sure to understand and romply 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 °-S finance charge. To arrange for a product return,simply call Customer Service as noted below: Henry Schein Medical 340B Program Henry Schein MedicalfEMS Customer Service: 1.000.472.4346£tarn-Spm,ct. Customer Service: 1.877.344.3402 8:30am-5:30pm.,I. Customer Service: 1.800.845.3550 8:3Wm 5:30pm,el, Place an Order: 1.800.772.4346 Bam-9pm,et. Place an Order: 1.877.344.3402 8:30am-5:301)m,et. Place an Order: 1.800-845.3550 8:30am-5:301)m,et. Fax an Order. 1.1100.329.9109 24 l lours. 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 Bam—bpm,et. Internet: www.henryschein.coni/encs E-Mail: custsery@henryschein.com Internet: ivww.henryschein.com/3400 E-Mail: scott.bruner@herryschein.com E-Mail: customer.support@henryschein.com Please see:littp://wwty.Henryschein.com,US-EN;Medical/LegalTerms.ASPX for Conditions&Fxcoptions. ORDER# I.. ATE 25105265 51 5 265 12/18/14 1 01/17/15 D&B#:01-243-0880 WHSEDEA# RHO162494 Fed ID: 1]-3136595 ggig a rhis order as been processed by our MIDWEST D.C. 5315 WES" 74TH =EET INDIANAPOLIS,IN 46268 rOM SMALL 12/18/14 1 602-8100 EA COLLAR STIFNECK SELECT ADULT 100 100 C 5.50 550.00 2 -_ASE GOOD =M, MAY BE SHIPPED SEPARATELY. 2 111-3107 25/PK BLUE SENSOR ELECTRODE ADULT 100 100 8.44 844.00 25 3 220-1398 3/ST BODY STRAP SET DISP YELLOW 100 100 5.75 575.00 25 4 990-5147 100/BX SHADOW PF NTRL GLOVE EXM X-LARGE 100 100 *C 7.00 700.00 14 --ASE GOOD I-EM, MAY BE SHIPPED SEPARATELY. 5 990-9832 100/BX ISHADOW PF NTRL GLOVE EXM LARGE 100 100 *C 7.00 700.00 24 --ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. ----------- - ------- PLEASE REFE TO BACK OF PAPERWORK FOR DISCLOSJRES/TE ZMS OF SALE MERCHAN= E TOTAL 3369.00 Invoice Date + 30 days 3369.00 Please remi payments only to the following address: Henry Schei , Inc. Dept CH 10211 Palatine, 1 60055-0241 BILL TO SI4IP To INVOICEINVOICE AMOUNT ITEM STATUS KEY EM Y School B-Backord red;Item will follow MKi t 1308571 1817102 15592931 3369.00 D-Discontinued; Item no longer available NC-No Charge F-Special offer ORDER# ORDER DATE INVOICE DATE to r If OF BOXES M-Manufacturer will ship Item directly to you P Prescription Drug:Return Authorization Required 25105265 12/18/14 12/18/14 26 R Refrigerated Item;May be shipped separately $ Special Schein Pricing CUSTOMER PO PAGE# T-Taxable Item � -Temporarily unavailable:Please reorder TOM SMALL 12/18 1 OF 1 Item has MSDS LP300 te.g.perrns mscournreaempaonsoromerspecialawarusf.wanyourpurchasesyoumayearn •ItemsTrialcannutoert.rurneutotnrrnaomacturer•HrryIternITIarKCMIMIIn:WrnaUM poirds/credits redeemable for certain goods or services,in accordance with discount program rules.Upon discount receipt by redemption at your earned points/credits,you are receiving or Equipment: will receive notice of the discount value.Accordingly,you should retain these records. Opened 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 netting exactly vvhat you ordered.Fquipment must be returned Unless otherwise agreed,freight lernrs are FOB Shipper's Duck("Ex Works'outside in the original unopenedpackaging,unmarked and properly packagod.Spoical order North America).Tille passes al the time the shipment is loaded at the shipper's dock. equipment is riot returnable.Alrequiprnent returns are subject to a restocking lee. Equipment is backed by the manufacturer's repair of replacement warrant;,.Please Continental U.S.: read and return all wartanty 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 manufacturer's additional carrier charges related to special delivery services and hazardous material warranty. shipments.Special orders are subject to additional freight charges. Prescription Dnlg Returns: Alaska.Hawaii&Pacific Protectorates: Please note Tlaat,in nrder to comply with Federal and State Pedigree requirements, Standard shipping methods pro,,ride 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 Protpctc rales Hx Drugs which Henry 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 vour invoice with the rode WH. No additional surcharges apply,except vrhen special services are requested. Rx Drugs which are purchased Lv Henry Schein directly from the manufacturer may Low-level hazardous Items(dangerous goods In accepted quantities and Consumer be returned providing that the toflowing kev elements are met Commodity ID 9000)are now,available via UPS 2nd-d&,y air. 1 Only returns drip to error in order or delivery will be allowed. Guam.Puerto Rico,U.S.Trust Territories&Virgin Islands: 2 Returns of Pox Drugs will only be.accepted if HSI is notified within 14 calendar days • NI orders will be subject to a handling charge.This charge includes freight throughof receipt of etre 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 F{x Drups • Special delivery orders.and hazardous material shipments can he shipped via United to complete and return a Prescription Drug Return Authorization form.Federar law Parcel SaP, f-s(t1PS)for an additional charge.No minimum order amount or weight requires that the healthcare entity returning Rx Drugs doc:urnent 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 toren and proper return Outside U.S. 50 states): authorization,please r;ontart 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 nternational Terms&Conditions at henr;rschefn.coIll.Unless other;vise agreed, Rx Drugs certifies freight tr;rms are FOR Shipper's Dock("Ex Works"outside North America). that the product being returned is the same exact product purchased trorn 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 ha',ve been Customer is responsible for compliance with any applicable rrnporl requirements. tampered with,are out of date or where the labeling has been altered in anyway. RX PRODUCTS & CONTROLLED SUBSTANCES: CHOOSEY©UR PAYMENT METHOD Regulations rhjuire us to limit the sale of Rx and oonlrolled substances only to registered, 2%Cash Back or Maximum Rewards on all purchases with the Henry Schein licenssi healthcare prolessionals.It-you are a new customer orhave rerentiy moved, Credit Card.To apply now,call 1.866.398.9296 or online please furnish us wiUr a copy of your updated state UFA registration.For controlled www.henryschein.com/creditcard Reduce the cost and administration of paying substances,furnish a copy of your DEA registration verifying your shipping address. HenrycheirrPa electronically ACH Debit or set u AutoPa Please note that all orders for controlltA substances art.,subject to a due diligenr:e review Please call Customer Service for details. ) p y process.Schedule II controlled substances can be ordered electronically or by mail. For information on our Controlled Substance Ordering System please visit For your convenience,'we provide several payment aiternatives.Orders billed to your kvoAv.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 Chock. If you prefer. II Schedule controlled substances,please mail the form to: you[nay riseyour 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 vour 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 Lural regulatury requirements may apply to use or installation of certain products. terms of sale. Be sure to understand and comply with arTy 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 8arn-11prn.et. Customer Service: 1.877.344.3402 8:30am-5:30pm.el. Customer Service: 1.800.1345.3550 8:3WnI-5:30Pm,Cl. Place an Order: 1.800.772.4346 Sana-9pm,et. Place an Order: 1.877.344.3402 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 Hours. Fax an Order. 1.888.885.2253 24 Flours. Fax an Order: 1.800.533.4793 24 Hours. Internet: www.henryschein.com/medical E-Commerce Support: 1.800.711.6032 8am-8pm,et. Internet: www.henryschein.com/encs E-Mail: custservghenryschein.corn Internet: www.henryschein.com/340B E-Mail: scoti.brun er@henryscheia.cum E-Mail: customecsupport0henryschein.com Please see:ltttp://www.Henryschain.com/US-EN/Medical/LegalTerms.AS PX for Conditions P.Fxreptions. 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)) 15321685 $11.16 15592931 $3,369.00 15529998 $89.91 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 �L $3,470.07 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 15321685 102-390.11 $11.16 1 hereby certify that the attached invoice(s), or 1120 15592931 102-390.11 $3,369.00 bill(s) is (are) true and correct and that the 1120 15529998 102-390.11 $89.91 materials or services itemized thereon for which charge is made were ordered and received except jAn nhr G 1 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund