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