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HomeMy WebLinkAbout333792 12/21/18 CITY OF CARMEL, INDIANA VENDOR: 357526 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $********81.64* 9� baa: CARMEL, INDIANA 46032 DEPT CH 10241 CHECK NUMBER: 333792 PALATINE IL 60055-0241 CHECK DATE: 12/21/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 60323755 81.64 SPECIAL DEPT -SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED z0 ACCOUNTS PAYABLE VOUCHER Vendor# 357526 HENRY SCHEIN INC IN SUM OF$ 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 $81.64 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 60323755 42-390.11 $81.64 1 hereby certify that the attached invoice(s),or 12/19/18 60323755 Misc.Supplies $81.64 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 Wednesday, December 19,2018 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 MEQ[X EMS Ship/Sold-To:1308572 INVOICE Carmel Fire Dept Head Quarters z Civic sq Carmel,IN 46032-7543 010000130857160323755110000000000081641213186 CCa�el FireDep71 2 Civic Sq Carmel,IN 46032-7543 CARMEL FIRE DEPT 2 CIVIC SQ CARMEL, IN 460327543 Invoice# Invoice Date Due Date Invoice Total 60323755 12/13/18 01/12/19 $81.64 Purchase Order# Payment Terms -- - --_ - 12132018 _..--invoice Date-+30 clays- Customer a s-Customer DEA# Customer State Reg# HSI Federal ID# HSI D&B# 11-3136595 01-243-0880 .:.i.., 4w C . ,.....�, ..a.A........:,.,s„i��.�..,'' :,_,x.�.._„�u�.xa. •y�n.;'.ppA.d�: ::,€.- .nn1::.&��!(Ayy�'<§....�,:�..`i.......jLC,�.,I.F€.'�,`�..:u:.=e:.,..;.... F�..,.s.�.:.'xn lip,l�w�F�w�..'..., ,...i.....« ...<€F.FF.....€ N:a€S..b�f':F$ .........:................�..........._....,a.. .._.E�., �'���€ ..,:...,.�.iF£.NM��.��n<«w,,..,..::.,..,u,���uwa`^...Y.w:. ...��a 3. .�•^��T��,��.'��' `a�,,,... 1 116-1786 144/CA Bag Emesis Sickness Clean-Up Sack 1 1 C 81.64 81.64 1 IN CASE GOOD ITEM,MAY BE SHIPPED SEPARATELY. MERCHANDISE TOTAL $81.64 INVOICE TOTAL $81.64 Please refer to back of paperwork for Terms of Sale and disclosures or go to https://www.henryschein.com/us-en/medicaMegaiterms.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 60323755 12/13/18 $81.64 C -Case Good Item SK-School Kit D -Discontinued;Item no longer available T -Taxable Item F -Special offer U -Temporarily unavailable;please reorder Order# Order Date #of Boxes PO# M -Item will ship directly from manufacturer W-Warranty Item 71061321 12/13/18 1 12132018 NC-No Charge WH,MN,M2,DN-DSCSA CODES P -Prescription Drug;Return Authorization Required$ -Special Schein Pricing *-Item has SDS Distribution Names/Address IN:5315 W 74th St Indianapolls,IN 46268 OEM.,RHO162494 SULe Re8R:48=176A Chem.Read:006574HMY Please remit Pavments to,Henry Schein,Inc.Dept CH 10241 Palatine,IL 60055-0241 US Page 1 of 1