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HomeMy WebLinkAbout333507 12/14/18 %' *"''`. CITY OF CARMEL, INDIANA VENDOR: 357526 t, ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $*****2,681.38* CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 333507 19;�rori�` PALATINE IL 60055-0241 CHECK DATE: 12/14/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 59619886 248.70 SPECIAL DEPT SUPPLIES 102 4467006 102131 59804050 2,015.00 STETHESCOPES 102 4239011 59869038 417.68 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 357526 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER HENRY SCHEIN INC IN SUM OF$ 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 wham,rates per day,number of hours,rate per hour,number of units,price per unit,etc. PALATINE, IL 60055-0241 Payee $2,015.00 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 102131 59804050 44-670.06 $2,015.00 1 hereby certify that the attached invoice(s),or 12/10/18 59804050 Stethoscopes $2,015.00 1120 102 1120 102 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, December 11,2018 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer HENRY SC�:E]NO ia Qn us- MEDICAL 1 BAS INVOICE Ship/Sold- 1308572 Carmel Fire Dept Head Quarters 2 Civic Sq Carmel,IN 46032-7543 Bill-To:1308571 010000130857159804050110000000002015001129188 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 598040501 11/29/18 12/29/18 $2015.00 Purchase Order# Payment Terms ------------------- - ._. ... ----------.- __. ......_....- ... ------.._._ ........- 102131.... Invoice Date+30-days--- Customer DEA# Customer State Reg# Federal ID#: D&B#: yy 11-3136595 01-243-0880 {yty� "a. tea" $ ::' L.'yak b I a aa.: �.- '"aac,a' , c ; a .� @>:,aa F S IGklr a s This is a backordered shipment for order.70232769 original invoice:59533698 1 114-1017 EA Stethoscope Littman Elec Bilk 27" 5 5 403.00 2,015.00 1 VA. i I MERCHANDISE TOTAL $2,015.00 INVOICE TOTAL $2,015.00 I 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 59804050 11/29/18 $2015.00 c -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 70232769 11/19/18 1 102131 NC-No Charge I WH,MN,M2,DN.DSCSA CODES P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing "-Item has SDS Distribution Names/Address VA(GM:80 SummitView Lane Basten,VA24314 DEAN:PG0229321 State Begg:0215000090 chem.Re N:008522GEY I Please remit vavments to,Henry Schein,Inc.Devt CH 10241 Palatine,IL 60055-0241 US Page 1 of 1 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 $666.38 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 59619886 42-390.11 $248.70 1 hereby certify that the attached invoice(s),or 12/10/18 59619886 Misc.Supplies $248.70 1120 102 1120 102 59869038 42-390.11 $417.68 bill(s)is(are)true and correct and that the 12/11/18 59869038 Misc.Supplies $417.68 1120 1 1 102 1 materials or services itemized thereon for 1120 102 which charge is made were ordered and received except Tuesday, December 11,2018 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 60 us, MEDICAL EMS • Ship/Sold-To:1308572 INVOICE Carmel Fire Dept Head Quarters 2 civic Sq Carmel,IN 46032-7543 Bill-To: 30 010000130857159619886110000000000248701121189 Carmel FireDeptl 2 Civic Sq Carmel,IN 46032-7543 CARMEL FIRE DEPT 2 CIVIC SQ CARMEL, IN 460327543 Invoice# Invoice Date Due Date Invoice Total 59619886 11/21/18 12/21/18 $248.70 -- -----..-..-------. ---------------.. - Purchase Order# Payment Terms - - - - 11212018--------------- -----Invoice- a e..+.. ..days- Customer s_Customer DEA# Customer State Reg# Federal ID#: D&B#: 11-3136595 01-243-0880 a k t og. .. �4`;d.' 3 'c r 0 F w� ' � Ills SfS>64 U111k xa � a � a 3VU CO33 :s SZX; $ rZ TSC1itQl� a .qggge xq 0 1 507-0341 EA Introcan Safety Catheter 24gX3/4" 50 50 1.72 86.00 2 IN 2 700-1184 EA Advanced Patient Mover 10 10 C 16.27 162.70 1 IN CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY. MERCHANDISE TOTAL $248.70 INVOICE TOTAL $248.70 Please refer to back of papenvork for Terms of Sale and disclosures or go to https://www.henryschein.com/us-en/medicaUlegaiterms.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 59619886 11/21/18 $248.70 C -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #Of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 70311943 11/21/18 2 11212018 NC-No Charge WH,MN,M2,DN-DSCSA CODES PNC- Prescription Drug;Return Authorization Required$ -Special Schein Pricing "-Item has SDS Distribution Names/Address IN'.5315 W.74th St Indianapolis,IN 46268 DEM.,RH01 62494 State Begf:48MI76A Chem.Begk 006574HNY Please remit Pavments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1 V�WCHEW a©h us- MEDICAL 'EMS New 4. Format -14 Ship/Sold-To:1308572 2CmclSge Dept Quarters INVOICE Carmel,IN 46032-7543 010000130857159869038110000000000417681130183 Carmel FireDept 1 2 Civic Sq Carmel,IN 46032-7543 CARMEL FIRE DEPT 2 CIVIC SQ CARMEL, IN 460327543 Invoice# Invoice Date Due Date Invoice Total 59869038 11/30/18 12/30/18 $417.68 Purchase Order# Payment Terms /1302018 _...... _. - _"Invoice-Date-­30-days—­ Customer -InvoiceDate-+ a s—_Customer DEA# Customer State Reg# Federal ID#: D&B#: 11-3136595 01-243-0880 "tk- " .o V. _ o 1,1 i... :, 7�hC ... 1 499-6737 EA Non-Rebreather Mask Adult 100 100 C .72 72.00 2 IN CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY. 2 220-2270 EA Thomas Holder VET Tube Adult 30 30 2.89 86.70 8 IN 3 220-1652 EA Collar Stifneck Select Pedi Cervical 40 40 C 5.53 221.20 5 IN CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY. 4 910-9375 24/CA Instant Warm Pack 6x9 2 2 C* 10.64 21.28 7 IN CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY. 5 900-4463 100/BX TB Syringe w/Needle Slip Icc 27gx1/2" 2 2 8.25 16.50 8 IN MERCHANDISE TOTAL 417.68 INVOICE TOTAL 417.68 Please refer to back of paperwork for Terms of Sale and disclosures or go to https://www.henryschein.com/us-en/medicalflegaiterms.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;Maybe shipped separately 1308572 1308571 59869038 11/30/18 $417.68 C -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 70570197 11/30/18 8 11302018 INC-No Charge WH,MN,M2,DN-DSCSA CODES P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing '-Item has SDS Distribution Names/Address IN:5315 LN 74th SL indierapdis,IN 46268 DFA#:RH0162494 We Reg#:480MI76A Chem Reg4:0065741-INY Please remit Pavments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1