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Home My WebLink About332167 11/13/18 ��(' """• CITY OF CARMEL, INDIANA VENDOR: 357526 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*******233.39* 4b� _� CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 332167 y�TON�� PALATINE IL 60055-0241 CHECK DATE: 11/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 58545808 58.62 SPECIAL DEPT SUPPLIES 102 4239011 58564955 174.77 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts city Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 357526 HENRY SCHEIN INC IN SUM OF$ CITY OF CARMEL DEPT CH 10241 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. PALATINE, IL 60055-0241 Payee $233.39 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 58564955 42-390.11 $174.77 1 hereby certify that the attached invoice(s),or 11/6/18 58564955 Misc.Supplies $174.77 1120 102 1120 102 58545808 42-390.11 $58.62 bill(s)is(are)true and correct and that the 11/6/18 58545808 Misc.Supplies $58.62 1120 1 1 102 1 materials or services itemized thereon for 1120 102 which charge is made were ordered and received except Tuesday, November 6, 2018 David Haboush Fire Chief 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— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer I tNkY CHEI opus- MEDICAL . Da • Ship/Sold-To:1308572 INVOICE Carmel Fire Dept Head Quarters z civic sq Carmel,IN 46032-7543 Bill-To:130571 010000130857158545808110000000000058621022182 Carmel Fire Dept 2 Civic Sq Cannel,IN 46032-7543 CARMEL FIRE DEPT 2 CIVIC SQ CARMEL, IN 460327543 Invoice# Invoice Date Due Date Invoice Total 58545808 10/22/18 11/21/18 $58.62 Purchase Order# Payment Terms - ---------._-..-- _-- _ 10012018 - ---invoice-Date+30 days Customer DEA# Customer State Reg# Federal ID#: D&B#: 11-3136595 01-243-0880 ;Lr sE ;'c .��1 401 Sill �£t This is a backordered shipment for order:68440986 original invoice:57843469 1 131-8235 EA Solution Multi Control 1&2 6 6 * 9.77 58.62 1 VA MERCHANDISE TOTAL 58.62 INVOICE TOTAL 58.62 Please refer to back of paperwork for Terms of Sale and disclosures or go to https://www.henryschein.com/us-en/medicalAegalterms.aspx.Such terms are incorporated herein by reference Thank you for your order! CODE STATUS KEY Ship To# Bill To# Invoice# Invoice Date Invoice Total B -Backordered;Item will follow R -Refrigerated Item;May be shipped separately 1308572 1308571 58545808 10/22/18 $58.62 C -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 68440986 10/01/18 1 10012018 NC-No Charge WH,MN,M2,DN-DSCSA CODES P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing '-Item has SDS Distribution Names/Address VA(GIV):80 Smnm4 View Lane Basi®¢,VA 24314 DEW PGOM321 State Regt:0215Ctk M Chem.Reg*C Please remit vavments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1 :HENkHEI MEDICAL ; El INVOICE Camel Head Carmel Fire Dept Head Quarters 2 Civic Sq Cannel,IN 46032-7543 Bill-To:130571 010000130857158564955110000000000174771022187 Carmel Fire Dept 2 Civic Sq Carmel,IN 46032-7543 CARMEL FIRE DEPT 2 CIVIC SQ CARMEL, IN 460327543 Invoice# Invoice Date Due Date Invoice Total 58564955 10/22/18 11/21/18 $174.77 Purchase Order# Payment Terms ------ --- --- — - -- — -- ----....----- 10222018 ----Invoice-Date--30 days--- Customer DEA# Customer State Reg# Federal ID#: D&B#: 11-3136595 01-243-0880 ham.(.:. ,< .�..,....::...... .... <..r..? 1 338-6201 361BX Bandage Self Adherent LF NS 2"x5yd 1 1 32.77 32.77 2 IN 2 890-4524 EA Kerlix Gauze Roll Ster 6P1y 4.5"x4.lyd 100 100 C 1.42 142.00 1 IN CASE GOOD ITEM,MAYBE SHIPPED SEPARATELY. MERCHANDISE TOTAL 174.77 INVOICE TOTAL 174.77 Please refer to back of paperwork for Terms of Sale and disclosures or go to https://www.henryschein.com/us-en/medicaUlegalterms.aspx.Such terms are incorporated herein by reference Thank you for your order! CODE STATUS KEY Ship To# Bill TO# Invoice# Invoice Date Invoice Total B -Backordered;Item will follow R -Refrigerated Item;May be shipped separately 1308572 1308571 58564955 10/22/18 $174.77 C -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 69215446 10/22/18 2 10222018 NC-No Charge WH,MN,M2,DN-DSCSA CODES P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing *-Item has SDS Distribution Names/Address Ilk 5315 w.74th St Indiarqd's,IN 46268 OFAl:RHO162494 State aegt 480M176A Chem Relit.CO 574HNY Please remit navments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1