HomeMy WebLinkAbout333089 12/11/18 %���''' CITY OF CARMEL, INDIANA VENDOR: 357526
ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*****1,689.18*
s9 j?� CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 333089
°j��roN�°' PALATINE IL 60055-0241 CHECK DATE: 12/11/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 59236038 268.04 SPECIAL DEPT SUPPLIES
102 4239011 59468356 1,148.20 SPECIAL DEPT SUPPLIES
102 4239011 59500563 242.64 SPECIAL DEPT SUPPLIES
102 4239011 59517030 30.30 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 357526 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
HENRY SCHEIN INC IN SUM OF$ 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
$1,689.18
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
59236038 42-390.11 $268.04 1 hereby certify that the attached invoice(s),or 11/28/18 59236038 Misc.EMS Supplies $268.04
1120 102 1120 102
59517030 42-390.11 $30.30 bill(s)is(are)true and correct and that the 11/28/18 59517030 Misc.EMS Supplies $30.30
1120 102 materials or services itemized thereon for 1120 102
59500563 42-390.11 $242.64 11/28/18 59500563 Misc.EMS Supplies $242.64
1120 102 which charge is made were ordered and 1120 102
59468356 42-390.11 $1,148.20 received except 11/28/18 59468356 Misc.EMS Supplies $1,148.20
1120 102 1120 102
Monday, December 3,2018
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
20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Customer DEA# Customer State Reg#
Federal ID#: D&B#:
11-3136595 01-243-0880
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1 499-6870 EA ET Tube Uncuffed 3.0 60 60 .96 57.60 5 FL
ESTIMATED DELIVERY DATE:11121118
2 499-7170 EA ET Tube Uncuffed 4.0 60 60 .96 57.60 4 IN
3 986-6186 50/BX Introcan Safety Cath Straight 18x1-1/4" 4 4 C 86.25 345.00 1 IN
CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY.
4 507-0313 EA Introcan Safety Catheter 20gXI.25" 200 200 C 1.72 344.00 2 IN
CASE GOOD ITEM,MAYBE SHIPPED SEPARATELY.
5 507-5531 EA Introcan Safety Catheter 22gX1" 200 200 C 1.72 344.00 3 IN
CASE GOOD ITEM,MAYBE SHIPPED SEPARATELY.
MERCHANDISE TOTAL $1,148.20
INVOICE TOTAL $1,148.20
Please refer to back of paperwork for Terms of Sale and disclosures or go to
https://www.henryschein.com/us-entmedicaUlegalterms.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 59468356 11/16/18 $1148.20 C -Case Good Item SK-School Kit
D -Discontinued;Item no longer available T -Taxable Item
F -Special offer U -Temporarily unavailable;please reorder
Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item
70158779 11/16/18 5 11162018 NC-No Charge WH,MN,M2,DN-DSCSA CODES
P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing *-Item has SDS
Distribution Names/Address
FL:WJ1 Jesse B Smith Ct Jac4wnS,Me,FL32219 JIN:531574lhStindiatmois,IN46268W
BEWRHM199SIaleRay#:22t315 DEM..RIi9i62494state
Reg#..4BOM176A
Chem.Re ff:C06781HNY Chem.Reg9:9C6574HNY
Please remit vavments to.Henry Schein.Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1
Customer DEA# Customer State Reg#
Federal ID#: D&B#:
11-3136595 01-243-0880
INN�61�i
z 4 i aF lm - d �Y £ x :;SHIP
a 3 �, hss a ar u ..., .. t .11 s FI8 � a � ....
£•SYt3 Y r. , S Y :, 17kSYI� t; ; f31p �CP�t q.• .•: qs: J'1lSC .
k a�
1 499-3940 EA Spur Resuscitator W/Mask Resv Adult 24 24 C 10.11 242.64 2 IN
CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY.
MERCHANDISE TOTAL $242.64
INVOICE TOTAL 5242.64
Please refer to back of paperwork for Terms of Sale and disclosures or go to
https://wNvw.henryscheirLcom/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 59500563 11/19/18 $242.64 c -Case Good Item SK-School Kit
D -Discontinued;Item no longer available T -Taxable Item
IF -Special offer U -Temporarily unavailable;please reorder
Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item
70193478 11/19/18 2 11192018 NC-No Charge WH,MN,M2,DN-DSCSA CODES
P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing '-Item has SDS
Distribution Names/Address
Itt 5315 6y 74th St Indiar4 ds,IN 46268
OFA#:RHO162494 State Begg:48001176A
Chem.Rey#:006574HUY
Please remit vavments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1
Customer DEA# Customer State Reg#
Federal ID#: D&B#:
11-3136595 01-243-0880
. ?. ,. .x,..€. :'E.aa. ...>>; ;
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1 890.0682 200/BX Webcol Alcohol Preps 2ply Large 10 10 * 3.03 30.30 1 IN
MERCHANDISE TOTAL $30.30
INVOICE TOTAL $30.30
Please refer to back of paperwork for Terms of Sale and disclosures or go to
https://www.henryschein.com/us-en/medical/legalterms.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 59517030 11/20/18 $30.30 C -Case Good Item SK-School Kit
D -Discontinued;Item no longer available T -Taxable Item
F -Special offer U -Temporarily unavailable;please reorder
Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item
70213058 11/19/18 1 11192018 NC-No Charge WH,MN,M2,DN-DSCSA CODES
P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing '-Item has SDS
Distribution Names/Address
lit 53151Y.74th St Ineianapd1s,IN 46268
DEM:RHO162494 State Reg#:4M 176A
chem.Rego:CM74HNY
Please remit.naviments to,Henry Schein,Inc.Dent CH 10241 Palatine,IL 60055-0241 US Page 1 of 1
Customer DEA# Customer State Reg#
Federal ID#: D&B#:
11-3136595 01-�2p43-08800
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..v.....i...,.., ...\\l\..a A.?,....c .,?a.
1 499-9268 20/BX LNCS PDTX Sensor(Pedi) 1 1 268.04 268.04 1 IN
MERCHANDISE TOTAL $268.04
INVOICE TOTAL $268.04
Please refer to back of paperwork for Terms of Sale and disclosures or go to
https://www.henryschein.com/us-en/medicalfegalterms.aspx.Such terms are incorporated herein by reference
Thank you for your order!
CODE STATUS KEY
Ship To# BIII To# Invoice# Invoice Date Invoice Total B -Backordered;Item will follow R -Refrigerated Item;May be shipped separately
1308572 1308571 59236038 11/09/18 $268.04 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
69917043 11/09/18 1 11092018 NC-No Charge WH,MN,M2,DN-DSCSA CODES
P -Prescription Drug;Return Authorization Required b -Special Schein Pricing '-Item has SDS
Distribution Names/Address
IDL 5315 W 74th St Indianapdis,IN 46268
DfA#:RHD162494 State Beg#:40n176A
Chem flet'&0965741-INY
Please remit payments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1