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HomeMy WebLinkAbout181931 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,784.52 k. CARMEL, INDIANA 46032 DEPT CH 10241 J PALATINE IL 60055 -0241 CHECK NUMBER: 181931 CHECK DATE: 2/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 1014856 -01 114.00 SPECIAL DEPT SUPPLIES 102 4467006 3001147 -01 846.00 EMS EQUIP 102 4467006 3001192 -01 44.10 EMS EQUIP 102 4239011 4121304 -01 417.60 SPECIAL DEPT SUPPLIES 102 4467006 7657962 -01 25.00 EMS EQUIP 102 4467006 9124838 -01 337.82 EMS EQUIP HENRY CHE N SHIP TO: Mato* Medical INVOICE Carmel Fire Dept Head Quarters MI 2 Civic Sq Carmel, IN 46032 -2584 135 Duryea Road, Melville, NY 11747 0100001, 30857104121304110010000000417600 ],11105 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 417.60 INVOICEII INVOICE DATE 4121304-01 1 /11 /10 CUSTOMER POli SHIP TO [MARK 1308572 Please detach here and mail the ahoy, with your payment WHSE DEA# Fed ID: 11-3136595 x r a 7 8, m 3d� Y.t '�mn,'a '3 r' s R o i bzm 9g 0 m OTICE OF T-IE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRICARE OR •THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY SUCH •EQUEST, SUCH VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINST THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THISE RECORDS. MERCHANDISE TOTAL 417,60 INVOICE TOTAL 417.60 PLEASE PAY WITHIN THIRTY (30) DAYS OF RECEIPT OF THIS NVOICE. 417.60 I•LEASE NOTE NEW REMIT TO ADDRESS I•lease remi: payments only to the following address: ENRY SCHEI:8 INC. •EPT CH 10241 •ALATINE, I, 60055 -0241 BILL TO INVOICES CUSTOMER Polf ITEM STATUS KEY REM KEY 1308571 4121304 -01 MARK 13- Backordered, Item will fellow SK- School Kit D Discontinued: hem no longer available NC No Charge SHIP TO INVOICE DATE OF BOXES F- Special Schein Free Goods M Manufacturer will ship luau diwdly to ,vbe 1308572 1/11/10 4 P Prescription Drug: Return Authorization Required R Refrigerated lien): May he. shipped separately INVOICE TOTAL PAGE ft Spacial Schein Pricing U Temporarily unavailable; please reorder 417.60 2 OF 2 T Taxable Item HENRY SCHEINP l Matrx Medical Riv 1 S OIF S ALE 'ay€ne, Teir ri We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCH IN CREDIT CARD catalog, hot -Aver, we reserve the right to make price adjustments in VISA, MASTERCAl D, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: or It you have tried a product and it is detective or does not perform Biii €r t Order To Your Open Account satisiactoril` we will provide a credit, refund, or exchange; it's your Available ;t choice. Simply call our customer service department within 3v days ybl t licensed dU ri pract Lion er in the J.S. Ai! invoices are p of receipt of the merchandise to arrange for the return. For a parade within 3u days. warranty repair or if you were scent something you did not ord -er, simply Bail: Rx Products Controlled Substances: Rilatrx Medical 800 845 -3550 Reguiations require us to limit the sale of Rx and controlled substances only to registered licensed healthcare professionals. If you are a nett customer or have recently moved, please furnish us with a copy of your updated state registration. For controlled substances furnish a copy of your DEA certificate, verifying your shipping address. Class II drugs can be ordered only by mail. International Orders: Ple ase, Mo We proudly serve healthcare professionals and governments Opened he ndpieces anti equipment may not be returned for throughout the world. To place orders or for inquiries on export credit but will be repaired or replaced in accordance with terms and conditions. please contact our Int ernational Department: manufacturer warranties, Before opening handpieces or 1-800-845-3550 equipment, we suggest that you check the shipping container and packing list to verity that you have received exactly :'tihat Prescription Drug Returns Instructions: you ordered.Opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for ail Prescription Drugs. Simply call our Customer Service Department 4'1-800-845-3550. LP300 WHSE DEA# Fed ID: 1 1- 3136595 ;P a, .:dR.« `��.v� ,.u<�, .«I« .e 4 sTa.�l�� aaK m a, xi� a i;_r e "r. �F K .A.,. 4C d`, This order as been processed by our NORTHEAST D.C. 41 WEAVER ROAD DENVER, ?A 17517 NARK HULET 317- 428 -878: 1 499 -8458 EA', NASAL CANNULA ADULT 300 300 C 0.38 114.00.. 6 THIS PRODUCT IS BEING SHIPPED FROM OUR MIDWEST DISTRIBUTION CENTER. CASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. IF YOU ARE •ARTICIPATING IN A DISCOUNT PROGRAM (E.G., POINTS, GIFTS OR 0 -_T t EARNED A CREDIT-TOWARD. 7PECIA i� "AWA DS "DIOCOv ^..T" 'WITH 'PHIS PURCHASE YOU HAVE GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE :N ACCO2DANCE WITH DISCOUNT PROGRAM RULES UPO DISCOUNT RECEIPT OR REDEMPTION, °OU ARE RECEIVING OR WILL RDCEIVE NOTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRICARE OR OTHER' PAYER MAY. REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY SUCH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINST THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. MERCHANDISE TOTAL 114.00 INVOICE TOTAL 114..00 PLEASE PAY WITHIN THIRTY(30) DAYS OF RECEIPT OF THIS NVOICE. 114.00 r BILL TO INVOICES CUSTOMER P0# ITEM STATUS KEY REM KEY 1308571 1014856 -01:• MARK li Backordered:hemwillIellow SK Schoolxil VOICE DATE OF BOXER I) Di Coulinued: I[cm no lunge, available NC No Charge IN SHIP TO I Special tiehein 1 roe Goods M Manutildture■ will ship Item directly to you 1817102 1 14 1 0 6 P PrcSaripion Drug: ketwn Authorization Required R Rclrigcratcd ltcm; May be stripped separately INVOICE TOTAL PAGES 5- Spacial Schein Pricing U Ten, pmarily unavailable.: please reorder 114.00 1 OF 2 T Taxahle Item Continued on Next Page L WWSE DEA# Fed ID: 1 1-3136595 r t ra 44%17_ r n M. r VD s t ,LC, s his order `las been'processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, 7A 17517 1 499 -2923 10 /CA GRAHAM MEGA.MOVER 1500 1 1 C 177.00 177.00• •1 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWEST DISTRIBUTION CENTER. ASE GOOD ITEM, MAY BE .SHIPPED SEPARATELY. 2 250 -9611 EA ACCU -CHEK CONTROL COMFORT HI /LO 12 12 8.25 99.00 2 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTION CENTER_ 3 677 -3721 EA BRASS OXYGEN REGULATOR 1 DISS 1 1 61.82 61.82 2 HIS PRODUCT -IS- ^BEING SHIPPED- OUR-.MIDWES -DISTR BUTTON .CENTER. IF YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER .PECIAL.AWAJDS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDIT TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE :N ACCO•DANCE WITH DISCOUNT PROGRAM RULES. :UPON DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEIVING OR WILL RECEIVE OTICE OF TEE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRICARE OR sTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY SUCH EQUEST, SUCH VALUE MUST BE DISCLOSED AS A DISCOUNT `GAINST THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD REMAIN TH SE RECORDS. MERCHANDISE TOTAL 337.82 INVOICE TOTAL 337.82 PLEASE PAY WITHIN THIRTY(30) DAYS OF RECEIPT OF THIS NVOICE. 337.82 BILL T0' INVOICE# CUSTOMER PO# KEY ITEM STATUS KEY REM KEY 1308571 .MARK 11- Backordered: Item wilI Ioilo w SK School Kit 17- Kiseennnued: In no longer available NC -Nn Chs¢pe SHIP TO INVOICE DATE OF BOXES P Special Schein Prim lioor5 M Islanulaclurer wild ship Item directly le you 1308572 1/ 13 1 0 2 P- Presunpiion Drug: Bean n Alnhoriiution Required INVOICE TOTAL PRGE# k kelneoraled Item: May he ,.hipped separately Special Schein Pricing U 'I'enlpnrflrily un:rvailahle; please reorder 337.82 1 OF 2 r- 'I'asable Item Continued on Next Page LPSOU WHSE DEA# Fed ID: 11-3136595 This order las been processed by our NORTHEAS D.C. 41 WEAVE' ROAD DENVER, PA 17517 MARK 317 -57 -2663 1 677 -8965 EA OXYGEN CYLINDER W /TOGGLE SIZE D 18 18 C 47.00 846.00 18 THIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTION CENTER. CASE GOOD I EM, MAY BE SHIPPED SEPARATELY. IF YOU ARE ARTICIPATING IN A DISCOUNT PROG ".1 (E.G., POINTS, GIFTS OR OTHER SPECIAL AWA S "DISCOUNT WITH THIS PURC 'SE YOU HAVE EARNED A CREDIT TOWARD GO0DS.OR SlRVICES, OR- REDEEMABLE N -ACCORDANCE -WITH DISCOUNT PROGRAM ..,._.4 RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI4ING OR WILL RECEIVE NOTICE OF THE DISCOUNT VALUE. FROM TIME TO TI'E, MEDICARE, MEDICAID, TRICARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY SUCH REQUEST, SUCH VALUE MUST BE DISCLOSED AS A DI.COUNT AGAINST THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDISE TOTAL 846.00 INVOICE TOTAL 846.00 PLEASE PAY WITHIN THIRTY(31) DAYS OF RECEIPT OF THIS INVOICE. 846.00 BILL TO IN/OICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 3001147701 MARK i3 Backordered: Item will follow SK School Kit SHIP Tr) I[NOhF DATE OF 1IORES D Discontinued: Item no longer available NC No Charge F Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 1/19/10 18 I Prescription Dive: Return Authorization Required INVOICE TOTAr, pAGEi3 R Refrigerated Item: May be shipped separately A Special Schein Pricing U Temporarily unavailahlc: please reorder 846.00 1 OF 2 T Taxable 'Lem Continued on Next Page WHSE DEA# Fed ID: 11-3136595 yE. i �`t; r MP ,o L'„ogn g�` e�� mss, o. AARK 317- 423 -8784 1 499 -2106 EA AC POWER CORD 1 1 25.00 25.00 ATTN: CHRISTINA LAERDAL APPROVED TO DROP SHIP 'ITH NO EXTIA COST JULIE BAKER 1 -800 -845 -3550 X328 YOUR ORDER 74298416 HAS BEEN SPLIT INTO MULTI SHIPMENTS. CERTAIN ITEMS WILL BE SHIPPED SEPARATELY. YOU WILL BE BILLED FOR THESE ITEMS RHEN THEY ARE SHIPPED. IF YOU ARE ?ARTICIPATING IN A DISCOUNT PROGRAM (E.G., POINTS, GIFTS OR OTHER SPECIAL AWA2DS "DISCOUNT")), WITH THIS PURCHASE YOU HAVE EARNED A CREDIT TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE :N ACCORDANCE WITH DISCOUNT PROGRAM RULES.._UPO'l DISCOUNT RECEIPT OR REDEMPTION, 'OOU ARE RECEI OR WILL RECEIVE NOTICE OF T-IE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRICARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY SUCH REQUEST, SUCH VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINST THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. MERCHANDISE TOTAL 25.00 INVOICE TOTAL 25.00 PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS NVTICE, 25.00 PLEASE NOTE NEW REMIT TO ADDRESS Please remi: payments only to the following address: HENRY SCHEIq INC. DEPT CH 10211' PALATINE, I.1 60055 -0241 BILL TO INVOICE# CUSTOMER PO#! ITEM STATUS KEY REM KEY 1308571 7657962 -01 MARK 1.- Backordered. Item will follow SK School Kit SHIP TO INVOICE DATE N OF BOXES Discontinued: Item no longer available NC No Charge I:- Special Schein Free Goods Manufacture' will .chip Gent'Meetly to you 1308572 1/12/10 P- Prescription Drug: Return nuthcti ration Required R Refrigerated Item: May be shipped eperau:]y INVOTCF TOTAL PACE@ S- Speeiat Schein Pricing U Temporarily unavailable: please reorder 25.00 1 OF 1 T- Tasahlc Gcm Payment Terms: We make every Etillort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT ARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guara nteed yMry�pg pA® g��g (,4wry'q��,/� yp �y /1 �'q p°p w wa at Guaranteed Satisfaction. k4" d0.ifrh or If you have tried a product and it is detective or does net perform Bill your Order To Your Open Account satisfactorily, we will provide a credit, refund, or exchange; it's your choice. Simply call our customer service department within 30 days payable e to within n 3 3C licensed says. dd practitioners in the U.S. A11 invoices are of receipt of the merchandise to arrange for the return. For a warranty repair or it you were sent something you did not order, simply all: Rx Products Controlled Substances: Matra Medical 1-800 -845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered. licensed healthcare professionals. It you are a nevi customer or have recently moved, please furnish us with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate, verifying your shipping address= Class 11 drugs can be ordered only by mail. International Orders: Please Note: We proudly serve healthcare professionals and governments Opened handpieces and equipment may not be returned for throughout the word. To place orders or for inquiries on export credit, but ill be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties, Before opening handpieces cr 1-800-845-3550 equipment, we suggest that you check the shipping container and packing list to verily that you have received exactly what you ordered.Opened Computer Software is not returnable. Prescription Drug Returns Instructions: Other restrictions may also apply. A Return Authorization is Required tor all Prescription Drugs. Simp=ly call our Customer Service Depai :r' -on: ©1-800-B45-3550. n <`ro x "ae A rww -a su�w.,�. ,..w. .W.,,�s z',a. ."vc LP300 WHSE DEA# Fed ID: 11- 3136595 n a gym ,n. rr �"k e his order as been processed by our NORTHEAST. D.C. 41 WEAVER ROAD DENVER, ?A 17517 1 499 -0776 5 /PK OXYGEN GASKET METAL 13 2 4.90 9.80 1 I•ARTIAL SHI'MENT WILL SHIP AND INVOICE WHEN AVAILA3LE. 2 499 -0776 5 /PK OXYGEN GASKET METAL 7 7 4.90 34.30 2 HIS PRODUCT IS BEING SHIPPED FROM OUR WEST COAST DI3TRIB LION CENTER. IF YOU ARE •ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINIS, GIFTS OR OTHER PECIAL` AwA'LS 1 "DISCOUNT")),'WITH'THIS PURCH?SE'YOti HAVE 2ARNEO A 'CREDI_' TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE :N ACCOZDANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, 70U ARE RECEI ING OR WILL RECEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRICARE OR •THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, •'D UPON ANY SUCH •EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSI THE PURCHASES THAT 1ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN TH ?SE RE•ORDS. MERCHANDISE TOTAL 44.10 INVOICE TOTAL 44.10 PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS NVOICE. 44.10 t 1 BILL TO INVOICE## 'CUSTOMER Mit r 1 ITEM STATUS KEY REM KEY 13 08 571 3001192-01 :MARK 11 tiackerdewd: Item will follow SK School Kit SHIP TO INVOICE DATE g OF BOXES D Di entinucd; Rem no longer available NC- No Charge j F Special Schein Free Goods M h4anutauur, will ship hem directly to you 1817102 1/19/10 2 1' Prescription Drug: Return Authorization Required INVOICE T(7TAt, ;`AGE# R- Refrigerated Item; May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder 44.10 1 OF 2 T- Taxable Item Continued on Next Page WHSE DEA# Fed ID: 11-3136595 6 tl� 4r i rti .E:i4 I Y ,d r .M1 m .r et a a•1 a k ,..'7:--77 a x .n a a his order has been processed by our NORTHEAST D.C. 41 WEAVER ROAD DENVER, PA 17517 1 565 -7365 100 /BX NITRILE PF GLOVE BLACK MEDIUM 10 10 7.99 79.90 3 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWEST DISTRIBUTION CENTER. 2 565 -0811 100 /BX NITRILE PF GLOVE BLACK X -LARGE 10 10 C 7.99 79.90 2 HIS PRODUCI IS BEING SHIPPED FROM OUR MIDWEST DISTRLBUTION CENTER. ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 3 565 -4216 100 /BX NITRILE PF GLOVE BLACK XX -LRG 10 10 7.99 79.90 3 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWEST DISTRIBUTION CENTER.. 4 565 -1031 100 /BX NITRILE PF GLOVE BLACK LARGE 10 10 7.99 79.90 3 HIS PRODUCI IS BEING SHIPPED FROM OUR MIDWEST DISTRIBUTION CENTER. 5 499 -0776 5 /PK OXYGEN GASKET METAL 20 20 4.90 98.00 1 OUR ORDER 4429833 HAS BEEN SPLIT INTO MULTI ?LE SHIPMENTS. CERTAIN ITEMS WILL :E SHIPPED .EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS HEN THEY ARE SHIPPED. IF YOU ARE `ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER .PECIAL AWA "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDIT TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE IN ACCO2DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, ':CU ARE RECEIVING OR WILL RECEIVE 1 1 I BILL TO INVOI rE#1 r[7.STOMEIx Pna ITEM STATUS K Y E REM KEY 1308571 4121304-01 MARK B Backordered: hem will follow SK School Kit 1) Discontinued: Item no longer available NC No Charge SHIP TO INVOICE DATE t! OF BOXER F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/11/10 4 P Prescription Drug: Return Authorization Required R Refrigerated Item: May he shipped separately INVOICE TOTAT, PAGEI 8 Special Schein Pricing U Temporarily unavailable; please reorder 417.60 1 OF 2 i T- Taxame Item Continued on Next Page VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,784.52 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 3001192 01 102 670.06 $44.10 I hereby certify that the attached invoice(s), or 1120 7657962 -01 102-670.06 $25.00 bill(s) is (are) true and correct and that the 1120 3001147 -01 102- 670.06 $846.00 materials or services itemized thereon for 1120 9124838 -01 102- 670.06 $337.82 1120 1014856 -01 102-390.11 $114.00 which charge is made were ordered and 1120 4121304 -01 102- 390.11 $417.60 received except FEB 1 2010 a Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3001192 -01 $44.10 7657962 -01 $25.00 3001147 -01 $846.00 9124838 -01 $337.82 1014856 -01 $114.00 4121304 -01 $417.60 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 Clerk- Treasurer