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Home My WebLink About333089 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 '�.iui -z ..,.-. :t. .: :.az�k�'& ..i`; i`�,*x �W. .< � kr '�i r thy. �� °�a � �F 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. ...>>; ; «a tY �� 1"'If" S. ' . 7� ,,. :.__� ..�..,. 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 \ "^. .inn �a�\`^:'•, �.'F\3': d \,.�'z ♦ ` ..... \ t Ckk 11,51tTYP> \(1 „:. \ RIGF7,; ..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