HomeMy WebLinkAbout257194 04/05/16 CITY OF CARMEL, INDIANA VENDOR: 357526
i ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $****10,582.22*
s. ?Q CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 257194
9.yi TON ` PALATINE IL 60055-0241 CHECK DATE: 04/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
252 5023990 28490555 332.22 OTHER EXPENSES
252 5023990 24794 28490555 10,250.00 MIHP STAT KIT WAIVED
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
vhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
nvoice Date invoice# Description Amount
Dept. Fund# (or note attached invoice(s) or bill(s))
03/28/16 28490555 $10,338.97
1120 252
03/28/16 24891346 $243.25
1120 252
1 hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
120—
Clerk-Treasurer
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
HENRY SCHEIN INC
DEPT CH 10241
IN SUM OF$
PALATINE, IL 60055-0241
$10,582.22
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members
24794 28490555 50-239.90 $10,338.97 1 hereby certify that the attached invoice(s), or
1120 252
24794 24891346 50-239.90 $243.25 bill(s) is(are)true and correct and that the
1120 252 materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 28, 2016
David Haboush
Fire Chief
Cost distribution ledger classification if
claim paid motor vehicle highway fund
r HENRY SCHEIN® Original Invoice
Invoice# 28490555
135 Duryea Road Customer Service Invoice Date: 03/10/16
Melville,NY 11747 1-800-472-4346
Amount 11,062.70
Terms : Statement date+20 days
Address Service Requested Due Date 04/15/16
Pagel of 2
4826002312 PRESORT 23122 AB 0.413 P1C21<B>
IlriirrlilII IIIlnIII II II II111 11111r1111111
Ship To:
CARMEL WELLNESS DEPARTMENT MD
2 CIVIC SQ Carmel Wellness Department MD
CARMEL IN 46032-2584
2 CIVIC Sq
Dr Michael Kaufmann
Carmel IN 460322584
Cust# :03327508 Ship Date :03/10/16 Sls Ord# :38815679
Cust P O# Ship Via :Drop Ship Sis Ord Dt:03/03/16
Sis Rep :M810
Tax
Item# Ship BO UOM Description Unit Price Amount Status
11133241 0 Ea i-STAT Blood Analysis System 10,250.0000 10,250.00 T
DIRECTLY HIPPED F OM THEM NUFACTURER
Please refer to back of paperwork for Disclosures/Terms of Sale
This Order Has been Shipped by our Henry Schein,Inc,Midwest Dist Center,5315 W 74th St Bldg 138,Indianapolis,IN 462685135
Finance Charges of 1.5%per month(18%per annum)are applied to amounts not paid within terms. Sub-Total10,250.00
No merchandise will be accepted for return without our authorization.All claims must be made within 10 days of invoice. Tax
Shipping and/or Handling 88.97
Total Amount
Tax ID#1 1-31 36595 DUNS#01-243-0880
r HENRY SCHEW Original Invoice BM
Invoice# 28491346
135 Duryea Road Customer Service Invoice Date: 03/07/16
Melville,NY 11747 1-800-472-4346
Amount 260.28
Terms : Statement date+20 days
Address Service Requested Due Date 04/15/16
Pagel of 2
Carmel Wellness Department MD Ship To:
2 Civic Sq
Carmel, IN 460322584 Carmel Wellness Department MD
2 Civic Sq
Dr Michael Kaufmann
Carmel IN 460322584
Cust# :03327508 Ship Date :03/07/16 Sls Ord# :38815679
Cust P O# Ship Via :United Parcel Zone 2 Sls Ord Dt:03/03/16
Sls Rep :M810
Tax
Item# Ship BO UOM Description Unit Price Amount Status
6310047 1 1 01 25/Bx I iSTAT CHEM8 Cartridge 1 238.0000 238.001 T
Please refer to back of paperwork for Disclosures/Terms of Sale
This Order Has been Shipped by our Henry Schein,Inc,Midwest Dist Center,5315 W 74th St Bldg 138,Indianapolis,IN 462685135
Finance Charges of 1.5%per month(18%per annum)are applied to amounts not paid within terns. Sub-Total 2t5.25
0
No merchandise will be accepted for return without our authorization.All claims must be made within 10 days of invoice. Tax
Shipping and/or Handling
Total Amount 1
I
Tax ID#1 1-31 36595 DUNS#01-243-0880
Medical Terms & Conditions
THE HENRY SCHEIN PRICE POLICY: RETURNS:
WE CANNOT ACCEPT ANY RETURNS WITHOUT PRIOR
We endeavor to maintain prices for the duration of a catalog,but we AUTHORIZATION.
reserve the right to make price adjustments in response to To arrange for a return,simply call our Customer Service department or contact your
manufacturers' price increases or extraordinary circumstances.Prices Sales Consultant.The following conditions must be complied with:
are subject to change without notice. •All returns must be accompanied by a copy of your invoice and a reason for the
return.
Henry Schein,Inc.('Henry Schein")and customer agree that the terms and conditions •Merchandise must be returned in its original unopened container,unmarked,and
hereinafter set forth shall govern the relationship between Henry Schein and the properly packaged.
customer to the extent that the parties do not have a written agreement in effect that •Returned products must have been purchased within the previous thirty(30)days.
conflicts with such terms and conditions.Customer acknowledges and accepts all such Any returns past thirty(30)days are subject to a restocking fee.
terms and conditions by placing an order for goods with Henry Schein,and upon Henry •Shortages or errors in shipments must be reported within seven(7)days of
Schein's delivery of the order to the customer. invoice date to issue credit(if applicable).
•Shipping charges will apply on all returns.
DISCOUNTS, REBATES AND DISCLOSURES:
Invoice or statement prices may reflect or be subject to a bundled discount or Exceptions:
rebate pursuant to a purchase offer,promotion,or discount program.You must The following special,customized,or government-regulated items are not returnable:
fully and accurately report to Medicare,Medicaid,Tricare and/or any other federal •Immune globulin products•Special order items(products that we do not ordinarily
or State program,upon request by such program,the discounted price(s)or net stock)•Personalized and imprinted items•Opened computer hardware and
price(s)for each invoiced item,after giving effect to any applicable discounts or software•Controlled substances•Hazardous materials•Expired products
rebates,which price(s)may differ from the extended prices set forth on your •Items that cannot be returned to the manufacturer•Any item marked
invoice.Accordingly,you should retain this invoice and all relevant information nonreturnable
for your records.It is your responsibility to review any agreements or other
documents,including offers or promotions,applicable to the invoiced Equipment:
_____products/prices to determine our purchase(s)are subject to a bundled _ Opened and used equipment may not be returned for credit.Before opening
discount or rebate.Any such discounts must 66e-E6 lculated pursuant to the terms_equipment,we-suggest that you-checkthe-shipping container and packing4ist to —-
of the applicable purchase offer,promotion,or discount program.Participation in ensure that you are getting exactly what you ordered.Equipment must be returned in
a promotional discount program is only permissible in accordance with discount the original unopened packaging,unmarked and properly packaged.Speical order
program rules.By participation in such program,you agree that,to your equipment is not returnable.All equipment returns are subject to a restocking fee.
knowledge,your practice complies with the discount program requirements. Equipment is backed by the manufacturer's repair or replacement warranty.Please
read and return all warranty information required immediately upon taking delivery of
DELIVERY TERMS: your new equipment.Open or defective equipment is subject to the manufacturer's
Unless otherwise agreed,freight terms are FOB Shipper's Dock("Ex Works"outside warranty.
North America).Title passes at the time the shipment is loaded at the shipper's dock.
Continental U.S.: Prescription Drug Returns:
All orders will be subject to a handling charge.This charge includes freight,except for Please note that,in order to comply with Federal and State Pedigree requirements,
additional carrier charges related to special delivery services and hazardous material Henry Schein's policy on the return of Rx Drugs is as follows:
shipments.Special orders are subject to additional freight charges. Rx Drugs which Henrychein has purchased from wholesalers are not returnable.
Alaska.Hawaii&Pacific Protectorates: 9 rY
Standard shipping methods provide direct,reduced cost,expedited air delivery 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 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-level hazardous items(dangerous goods in accepted quantities and Consumer 1)Only returns due to error in order or delivery 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
Guam.Puerto Rico,U.S.Trust Territories&Virgin Islands: of receipt of the shipment and valid return authorization is issued by HSI.
•All orders will be subject to a handling charge.This charge includes freight through 3)The Prescription Drug Marketing Act requires any customer returning Rx Drugs to
the United States Postal Service(USPS). complete and return a Prescription Drug Return Authorization form.Federal law
•Special delivery orders and hazardous material shipments can be shipped via United requires that the healthcare entity returning Rx Drugs document that the product
Parcel Services(UPS)for an additional charge.No minimum order amount or weight was kept under proper storage and handling conditions while in their possession
applies.Speak to your International Representative for details. 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 Rx
International Terms&Conditions at henryschein.com.Unless otherwise agreed, Drugs certifies that the product being returned is the same exact product purchased
freight terms are FOB Shipper's Dock("Ex Works"outside North America). 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.
RX PRODUCTS & CONTROLLED SUBSTANCES: CHOOSE YOUR PAYMENT METHOD
Regulations require us to limit the sale of Rx and controlled substances only to 2%Cash Back or Maximum Rewards on all purchases with the Henry
registered,licensed healthcare professionals.If you are a new customer or have Schein Credit Card.To apply now,call:1.866.398.9296 or online
recently moved,please fumish us with a copy of your updated state DEA registration. www.henryschein.com/creditcard Reduce the cost and administration
-- — — of-paying Henn -Schein -elpctronicall _ACH-Debit-orselt up—
shipping
-"For controfied substances,furnish-a copy of-yourDtA registration verityirgyour AUtOPa 9 Y Y Y{ )
address. Y
Please note that all orders for controlled substances are subject to a due diligence Please call Customer Service for details.
review process.Schedule II controlled substances can be ordered electronically or by For your convenience,we provide several payment alternatives.Orders billed to your
mail. account may be paid by ACH Debit,Check by Phone,or Check.If you prefer,you
For information on our Controlled Substance Ordering System please visit may useyour Henry Schein Credit Card,American Express,Visa,MasterCard or
www.henryschein.com/e222;if you prefer to continue using Federal 222 Forms to order Discover Card when placing your order.All sales are subject to our normal terms and
Schedule II controlled substances,please mail the form to: conditions.All sales are subject to credit approval.Invoices are payable within agreed
Henry Schein,Inc.•Suite 300,5315 West 74th Street•Indianapolis,IN 46268 terms of sale.
Open Accounts Receivable:
REGULATORY REQUIREMENT: All unpaid accounts receivable past due are subject to a 1.5%finance charge.
Local regulatory requirements may apply to use or installation of certain products.
Be sure to understand and comply with any such requirements prior to purchase,use,
or installation of products.
To arrange for a product return,simply call Customer Service as noted below:
Henry Schein Medical 340B Program Henry Schein Medical/EMS
Customer Service:1.800.472.4346 8am9pm,at. Customer Service: 1.877.344.3402 8:30am5:30pm,et. Customer Service:1.800.845.3550 8:30am5:30pm,et.
Place an Order: 1.800.772.4346 8am9pm,et. Place an Order: 1.877.344.3402 8:30am5:30pm,et. Place an Order: 1.800.845.3550 8:30am5:30pm,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 8am8pm,et. Internet: www.henryschein.com/ems
E-Mail: custserv@henryschein.com Internet: www.henryschein.com/3408 E-Mail: scott.bruner@henryschein.com
E-Mail: customer.support@henryschein.com
Please see:http://www.Henryschein.com/US-EN/Medical/LegaiTerms.ASPX for Conditions&Exceptions.
Page 2 of 2
Medical Terms & Conditions
THE HENRY SCHEIN PRICE POLICY: RETURNS:
WE CANNOT ACCEPT ANY RETURNS WITHOUT PRIOR
We endeavor to maintain prices for the duration of a catalog,but we AUTHORIZATION.
reserve the right to make price adjustments in response to To arrange for a return,simply call our Customer Service department or contact your
manufacturers' price increases or extraordinary circumstances.Prices Sales Consultant.The following conditions must be complied with:
are subject to change without notice. •All returns must be accompanied by a copy of your invoice and a reason for the
return.
Henry Schein,Inc.("Henry Schein")and customer agree that the terms and conditions •Merchandise must be returned in its original unopened container,unmarked,and
hereinafter set forth shall govern the relationship between Henry Schein and the properly packaged.
customer to the extent that the parties do not have a written agreement in effect that •Returned products must have been purchased within the previous thirty(30)days.
conflicts with such terms and conditions.Customer acknowledges and accepts all such Any returns past thirty(30)days are subject to a restocking fee.
terms and conditions by placing an order for goods with Henry Schein,and upon Henry •Shortages or errors in shipments must be reported within seven(7)days of
Schein's delivery of the order to the customer. invoice date to issue credit(if applicable).
0 Shipping charges will apply on all returns.
DISCOUNTS, REBATES AND DISCLOSURES:
Invoice or statement prices may reflect or be subject to a bundled discount or Exceptions:
rebate pursuant to a purchase offer,promotion,or discount program.You mustThe following special,customized,or government-regulated items are not returnable:
fully and accurately report to Medicare,Medicaid,Tricare and/or any other federal •Immune globulin products Special order items(products that we do not ordinarily
or State program,upon request by such program,the discounted price(s)or net stock)•Personalized and imprinted items•Opened computer hardware and
price(s)for each invoiced item,after giving effect to any applicable discounts or software•Controlled substances•Hazardous materials•Expired products
rebates,which price(s)may differ from the extended prices set forth on your •Items that cannot be returned to the manufacturer•Any item marked
invoice.Accordingly,you should retain this invoice and all relevant information nonreturnable
for your records.It is your responsibility to review any agreements or other
documents,including offers or promotions,applicable to the invoiced Equipment:
to determine if_ our purchase(s)are subject to a bundled Opened and used equipment may not be returned for credit.Before opening
products/prices— Y p--(-)- -s subject ------ - e ui ment,-we-su est that you checkthe-shi the-shipping container and packing-list list to-
~-' discount or rebate.Any such discounts must tie calculated pursuant to the terms q p 99 y Pp g p g
of the applicable purchase offer,promotion,or discount program.Participation in ensure that you are getting exactly what you ordered.Equipment must be returned in
a promotional discount program is only permissible in accordance with discount the original unopened packaging,unmarked and properly packaged.Speical order
program rules.By participation in such program,you agree that,to your equipment is not returnable.All equipment returns are subject to a restocking fee.
knowledge,your practice complies with the discount program requirements. Equipment is backed by the manufacturer's repair or replacement warranty.Please
read and return all warranty information required immediately upon taking delivery of
DELIVERY TERMS: your new equipment.Open or defective equipment is subject to the manufacturer's
Unless otherwise agreed,freight terms are FOB Shipper's Dock("Ex Works"outside warranty.
North America).Title passes at the time the shipment is loaded at the shipper's dock.
Continental U.S.: Prescription Drug Returns:
All orders will be subject to a handling charge.This charge includes freight,except for Please note that,in order to comply with Federal and State Pedigree requirements,
additional carrier charges related to special delivery services and hazardous material Henry Schein's policy on the return of Rx Drugs is as follows:
shipments.Special orders are subject to additional freight charges.
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 delivery 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 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. 1 Only returns due to error in order or delivery will be allowed.
Low-level hazardous items(dangerous goods in accepted quantities and Consumer ) Y rY
CommodityID 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
Guam.Puerto Rico,U.S.Trust Territories&Virgin Islands: of receipt of the shipment and valid return authorization is issued by HSI.
•All orders will be subject to a handling charge.This charge includes freight through 3)The Prescription Drug Marketing Act requires any customer returning Rx Drugs to
the United States Postal Service(USPS). complete and return a Prescription Drug Return Authorization form.Federal law
•Special delivery orders and hazardous material shipments can be shipped via United requires that the healthcare entity returning Rx Drugs document that the product
Parcel Services(UPS)for an additional charge.No minimum order amount or weight was kept under proper storage and handling conditions while in their possession
applies.Speak to your International Representative for details. 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 Rx
International Terms&Conditions at henryschein.com.Unless otherwise agreed, Drugs certifies that the product being returned is the same exact product purchased
freight terms are FOB Shipper's Dock("Ex Works"outside North America). 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.
RX PRODUCTS & CONTROLLED SUBSTANCES: CHOOSE YOUR PAYMENT METHOD
Regulations require us to limit the sale of Rx and controlled substances only to 2%Cash Back or Maximum Rewards on all purchases with the Henry
registered,licensed healthcare professionals.If you are a new customer or have Schein Credit Card.To apply now,call:1.866.398.9296 or online
recently moved,please furnish us with a copy of your updated state DEA registration. www.henryschein.com/creditcard Reduce the cost and administration
- - Forcontrolled substances,-famish a copy of-your DEA registration verifying your - - of paying Henry SCheinPay electronically(AGH-Debit)or cet-up---
shipping address. AutoPay.
Please note that all orders for controlled substances are subject to a due diligence Please call Customer Service for details.
review process.Schedule II controlled substances can be ordered electronically or by For your convenience,we provide several payment alternatives.Orders billed to your
mail. account may be paid by ACH Debit,Check by Phone,or Check.If you prefer,you
For information on our Controlled Substance Ordering System please visit may useyour Henry Schein Credit Card,American Express,Visa,MasterCard or
www.henryschein.com/e222;if you prefer to continue using Federal 222 Forms to order Discover Card when placing your order.All sales are subject to our normal terms and
Schedule II controlled substances,please mail the form to: conditions.All sales are subject to credit approval.Invoices are payable within agreed
Henry Schein,Inc.•Suite 300,5315 West 74th Street•Indianapolis,IN 46268 terms of sale.
Open Accounts Receivable:
REGULATORY REQUIREMENT: All unpaid accounts receivable past due are subject to a 1.5%finance charge.
Local regulatory requirements may apply to use or installation of certain products.
Be sure to understand and comply with any such requirements prior to purchase,use,
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 8am9pm,at. Customer Service: 1.877.344.3402 8:30am5:30pm,et. Customer Service:1.800.845.3550 8:30am5:30pm,et.
Place an Order: 1.800.772.4346 8am9pm,at. Place an Order: 1.877.344.3402 8:30am5:30pm,et. Place an Order: 1.800.845.3550 8:30am5:30pm,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 8am8pm,et. Internet: www.henryschein.com/ems
E-Mail: custserv@henryschein.com Internet: www.henryschein.com/340B E-Mail: scott.bruner@henryschein.com
E-Mail: customer.support@henryschein.com
Please see:http://www.Henryschein.com/US-EN/Medical/LegaiTerms.ASPX for Conditions&Exceptions.
Page 2 of 2