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Home My WebLink About244718 04/29/15 CITY OF CARMEL, INDIANA VENDOR: 357526 u; tS ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $"'"""51.44' CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 244718 9M�roii PALATINE IL 60055-0241 CHECK DATE: 04/29/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 18729982 51.44 SPECIAL DEPT SUPPLIES ease detach here anti mail the above withyourpayment ORDER# ORDER DATE IDUE DATE 28123541 04/13/15 05/13/15 D&B#:01-243-0880 WHSE DEA# RHO]62494 Fed ID:11-3136595 1114 1=011� ENhis order has been processed by our MIDWEST .C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 ON 317-571-2660 1 145-0508 EA STETHOSCOPE ADSCOPE 2HD 22" 2 2 25.72 51.44 1 LEASE REFEZ TO BACK OF PAPERWORK FOR DISCLOS ES/TE S OF SALE /F: ATTN J N ALVERSON MERCHANDI E TOTAL 51.44 Invoice Date + 30 days 51.44 Please remi payments only to the following a dress: Henry Schei , Inc. Dept CH 10211 Palatine, I 60055-0241 BILL TO SHIP TO INVOTCF4INVOICE MOUNT ITEM STATUS KEY REM KEY 1308571 1308572 18729982 51.44 B-Backordered;Item will follow SK-School Kit D-Discontinued;Item no longer available NC-No Charge QRDER# ORDER F-Special offerINVOTCE DATE # OF M-Manufacturer will ship Item directly to you P-Prescription Drug;Return Authorization Required 28123541 04/13/15 4/13/15 1 R-Refrigerated Item;May be shipped separately ME $ -Special Schein Pricing T-Taxable Item JON 041015 1 OF 1 U-Item has MSDS unavailable;please reorder LP300 rnnrryxoreviewanyagreemenworeweraocumums, •Items that cannot be returned to the manufacturer•Any item marked nonreturnable including offers or promotions,applicable to the invoiced products/prices to determine if your purchase(s)are subject to a bundled discount or rebate.Any such discounts must be Equipment: calculated pursuant to the terms of the applicable purchase offer,promotion,or discount Opened 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 list to 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 with the discount program requirements. in tie original unopenedpackaging,unmarked and properly packaged.Speical order equipment is not returnable.All equipment returns are subject to a restocking tee. DELIVERY TERMS: Equipment is backed by the manufacturer's repair or replacement warrant,.Please Unless otherwise agreed,freight terms are FOB Shipper's Dark('Ex Works"outside read and return all warranty information required immediately upon Lakin delivery of North America).Title passes at the time the shipment is loaded at the shipper's dock. your neer equipment.Open or defective equipment is subject to the manufacturer s Continental U.S.: warranty. All orders will be subject to a handling charge.This charge includes freight,except for Prescription Drug Retums: additional carrier charges related to special delivery services and hazardous material Please note tt�at,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 Pox 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 code WH. service to all accounts in Alaska and Hawaii.Customers in the Pacific Protectorates Rx Drugs which are purchased 15y Henry Schein directly from the manufacturer may are offered direct surface transport,or postal services for reliable delivery. be returned providing that the fofiowing key elements are met: No additional surcharges apply,except when special services are requested. Low-level hazardous items(dangerous goods in accepted quantities and Consumer 1)Only returns due to error in order or delive�r will be allowed. Commodity ID 8000)are now available via UPS 2nd-day air. 2)Returns of Rx Drugs will only be accepted if HSI is notified within 14 calendar days of receipt of the shipment and valid return authorization is issued by HSI. Guam,Puerto Rico.11 S.Trust Territories&Virgin Islands: 3)The Prescription Drug Marketing Act requires any customer returning Rx Drugs • All orders will be subject to a handling charge. Ihis charge includes freight through 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 document that 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 International Representative for details. authorization,please contact Customer Service. Outside U.S.(50 states): 4)In addition,Pedigree regulations require that tie healthcare entity returning f your order is being shipped outside the U.S.(50 states),please refer to the Rx Drugs certifies international Terms&Conditions at henryschein.com.Unless otherwise agreed, that the product being returned is the same exact product purchased from HSI. freightterms are FOB Shipper's Dock("Ex Works"outside North America). 5)Henry Schein will not issue credit for any returner]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 impo"re uirements_ v T RX PRODUCTS& CONTROLLED SUBSTANCES: CFIOGSC�OUR-PAYMENs nall pHOD— Regulations require us to limit the sale of Rx and controlled substances only to registered, Credit 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 us with a copy of your updated state DEA registration.For controlled www.henryschein.com/creditcard Reduce the cost and administration of paying substances,furnish a copy of your DFA registration verifying your shi ping 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 II 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 please visit account may be pair)by ACH Debit,Check by Phone,or Check.If you prefer. www.henryschein.com/6222;if you prefer to continue using Federal 222 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 conditions.All sales are subject to credit approval.Irrvoices are payable within agreed REGULATORY REQUIREMENT: terms of sale. Local regulator requirements may ap ly to use or installation of certain products. Open Amounts Receivable: Be sure to understand and comply w I 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 3408 Program Henry Schein Medical(EMS Customer Service: 1.800.472.4346 Oam-9pm,et. Customer Service: 1.877.344.3402 8:30am-5:30pm,el. Customer Service: 1.800.845.3550 8:30ani-5:30pin,et. Place an Order: 1.800.772.4346 8am-9pm,et. Place an Order. 1.877.344.3402 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 Hours. Fax an Order: 1.888.865.2253 24 Hours. Fax an Order. 1.800.533.4793 24 Hours. Internet: %vvnv.henryschein.com/medical E-Commerce Support: 1.800.711.6032 8am-Bpm,et. Internet: www.henryschein.com/erns E-Mail: custsery*henryschein.com Internet: ivvnv.henryschein.com/340B E-Mail: scott.bruner@henryschein.com E-Mail: custom er.support0henryschein.com Please see:http-//www.Henryschein.com/US-EN/Medical/Lega[Terms.AgPX for Conditions&Exceptions. I VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ i Dept Ch 10241 Palatine, IL 60055 $51.44 I ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 18729982 102-390.11 $51.44 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 j received except APR 2 2015 &WAA& Affii— A I 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)) 18729982 $51.44 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 5-11-10-1.6 120 Clerk-Treasurer