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Home My WebLink About243727 03/31/15 ��..c *. CITY OF CARMEL, INDIANA VENDOR: 357526 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $'•"""'"851.08' s, ,; CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 243727 °.y«oN.�o. PALATINE IL 60055-0241 CHECK DATE: 03/31/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 18006552 851.08 SPECIAL DEPT SUPPLIES ORDER# ORDER DATE DUE DATE 27433411 03/18/15 04/17/15 D&B#:01-243-0880 WHSE DEA# RHO 162494 Fed ID: 11-3136595 a e s ,11 Q � s in his order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 - - - - - - - ----------- ------- 1 935-6155 50/PK BLUE SENSOR SP ELECTRODES 50 50 12.08 604.00 4 2 153-6648 100/BX BIOHAZARD BAG 23X23 RED 2311X23" 2 2 12.29 24.58 4 3 565-7365 100/BX NITRILE PF GLOVE BLACK MEDIUM 25 25 8.90 222.50 4 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOSIJRES/TEZMS OF SALE ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 851.08 nvoice Date + 30 days 851.08 lease remi payments only to the following a dress: enry Schei , Inc. .Dept CH 102 1 Palatine, I 60055-0241 BILL TO SHIPE AMOUNT ITEM STATUS KEY REM KEY B-Backordered;Item will follow SK-School Kit 1308571 1308582 18006552 851.08 D-Discontinued;Item no longer available NC-No Charge F-Special offer ORDER# ORDER DATE INVOICE DATEE M-Manufacturer will ship Item directly to you P-Prescription Drug;Return Authorization Required 27433411 03/18/15 3/18/15 4 R-Refrigerated Item;May be shipped separately $ -Special Schein Pricing CUSTOMER POO PAQE# T-Taxable Item 0 31715 1 OF 1 U-Temporarily unavailable;please reorder *-Item has MSDS purchases)are subject to a bundled dlscourd or rebate.Arty such discounts must he Equipment: calculated pursuant to the terms of the applicable purchase offer,promotion,or discount Opened and used equipment may not be returned for credit.Before opening program.Participation in a promotional discount program is only permissible In accordance equipment,we suggest that you check the shipping container and packing lislto with discount program rules.By participation in such program,you agree that,to your ensure that you are getting exactly what you ordered.Equipment must be returned knowledge,your practice complies withthe discount program requirements. in the original unopened packaging,unmarked and properly packaged.Speical order equipment is not returnable.At equipment returns are subject to a restocking fee. DELIVERYTERMS: Equipment is backed by the manufacturer's repair or replacement warranty.Please Unless otherwise agreed,freight terms are FOB Shipper's Dock('Ex Works"outside read and return all warranty information required immediately upon taking delivery of North America).Title passes at the time the shipment is loaded at the shipper's dock. your new equipment.Open or defective equipment is subject to the manufacturers Continental U.S.: warranty. All orders will be subject to a handling charge.This charge includes freight,exceptfor Prescription Dnag_Fietums: additional carrier charges related to special delivery services and hazardous material Please note that,in order to comply with Federal and State Pedigree requirements, shipments.Special orders are subject to additional freight charges. Henry Schein's policy on the return of Rx Drugs is as follows: Alaska.Hawaii&Pacific Protectorates: Rx Drugs which Henry Schein has purchased from wholesalers are not returnable. Standard shipping methods provide direct,reduced cost,expedited air deliver; These items will be identified in your invoice with the rode WH. service to all accounts in Alaska and.Hawaii.Customers in the Pacific Protectorates Rx Drugs which are purchased by Henry Schein directly from the manufacturer may are offered direct surface transport,or postal services for reliable delivery. be returned providing that the following key elements are met: - No additional surcharges apply,except when special services are requested. Low-ley�,l hazardous items(dangerous goods in accepted quantities and Consumer 1 Only returns due to error in order or delive�p�will be allowed. Commo`'lity ID 3000)are now available via UPS 2nd-day air. 2�Returns of Rx Drugs will only be accepted ff HSI is notified within 14 calendar days Guam.Puerta Rico.U.S.Trust Territories&Urg in Islands: of receipt of the shipment and valid return authorization is issued by HSI. 3)The Prescription Drug Marketing Act requires any customer returning Rx Drugs • All orders will be subject to a handling charge.This charge includes treightthrough to complete and return a Prescription Drug Return Authorization form.Federal law the United States Postal Service(USPS). requires that the healthcare entity returning Rx Drugs documentttiat the product • Special delivery orders and hazardous material shipments can be shipped via United was kept under proper storage and handling conditions while in their possession Parcel Services(UPS)for an additional charge.No minimum order amount orweight and during the return of the product.'To get a copy of the form and proper return applies.Speak to your Internalional Representative for details. authorization,please contact Customer Service. Outside U.S.(50 slates): 4)In addition,Pedigree regulations require that tie healthcare entity returning if your order is being shipped outside the U.S.(50 states),please refer to the Rx Drugs certifies International Terms&Conditions at hen schein.com.Unless otherwise agreed, that the product being returned is the same exact product purchased from HSI. rl' d p 9. fret ht terms are FOB Shipper's Dock "Ex Works"outside North America). r r g pp ,( ) 5)Henry Schein will not issue credit for any returned Rx Drugs which have been Title passes at the time the shipment is loaded at the shipper's dock. tampered with,are out of date or where the labeling has been altered in any way. Customer is responsible for compliance with any applicable import requirements. CHOOSE YOUR PAYMENT METHOD -- - RX PRO DUCTS-L-CONTROLLED-SUBSTANCES:-_ ---21/oCash-Back or Maximum-Reivards on-all-purchases-witli-the-Henry-Schein___ Regulations require us to limit the sale of Rx and controlled substances only to registered, Credit Card.To apply now,call:1.866.398.9296 or online licensed healthcare professionals.If you are a new customer or have recently moved, vtww.henr schein.com/creditcard Reduce the cost and administration of m please furnish us with a copy of your updated state DEA registration.For controlled Y 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 subject to a due diligence review Please call Customer Service for details. process.Schedule 11 controlled substances can be ordered electronically or by mail. For your convenience,we provide several payment alternatives.Orders billed to your For information on our Controlled Substance Ordering System pleasevisit account may be paid by ACH Debit,Check by Phone,or Check.If you prefer. www.henryschein.com/e222;if you prefer to continue using Federal 227-Forms to order you may useyour Henry Schein Credit Card,American Express,Visa,MasterCard or Schedule II controlled substances,please mail the form to: Discover Card when placing your order.All sales are subject to our normal terms and Henry Schein,Inc.• Suite 300,5315 West 74th Street • Indianapolis,IN 46268 c;onditions.A11 sales are subject to credit approval.Invoices are payable within agreed REGULATORY REQUIREMENT: terms of sale. Local regulatory requirements may apply to use or installation of certain products. Open Accounts Receivable: Be sure to understand and comply with any such requirements prior to purchase,use, All unpaid accounts receivable past due are subject to a 1.5%finance charge. or installation of products. To arrange for a product return,simply call Customer Service as noted below: Henry Schein Medical 34OB Program Henry Schein MedlcalfEMS Customer Service: 1.800.472.4346 Barn-9pin,et. Customer Service: 1.877.344.3402 8:30ani-:5:30prn,el. Customer Service: 1.600.845.3550 8:30ani-5:30pm,et Place an Order: 1.800.772.4346 Bari-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 Hours. Fax an Order. 1.800.533.4793 24 flours. Internet: ivww.henryschein.com/medical E-Commerce Support: 1.800.711.6032 Sam-Spm,et. Internet: www.henryscliein.com/ems E-Mail: custserv@shenryschein.com Internet: %vvriv.henryschein.corn/3406 E-Mail: scott.bruner@henryschein.com E-Mail: customer.support@henrVschein.com Please see:littp://www.Henryschein.com/US-EN/Medical/LegalTerms.ASPX for Conditions&Exceptions. LP300 VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF$ Dept Ch 10241 Palatine, IL 60055 $851.08 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT Board Members 1120 18006552 102-390.11 $851.08 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 i which charge is made were ordered and received except MAR 2 0 9015 C I Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund . II 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)) 18006552 $851.08 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