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Home My WebLink About182377 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $2,358.05 +4,+ PALATINE IL 60055 -0241 CHECK NUMBER: 182377 CHECK DATE: 2/17 /2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 3001192 -02 53.90 SPECIAL DEPT SUPPLIES 102 4467006 4901131 -01 239.05 EMS EQUIP 102 4239011 4901191 -01 1,908.30 SPECIAL DEPT SUPPLIES 102 4239011 5407220 -01 156.80 SPECIAL DEPT SUPPLIES WHSE DEAD# Fed ID: 11-3136595 iAv r' his order as been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751-7 1 499 -0776 5 /PK OXYGEN GASKET METAL 11 11 4.90 53.90 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA ZDS "DISCOUNT WITH THIS PURCIL,SE YOU HAVE ARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, 'IOU ARE RECEI ING OR WILL RECEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 53.90 INVOI E TOTAL 53.90 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 53.90 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: H ENRY SCHE14 INC. D EPT CH 10211 ALATINE, I 60055 0241 z TO INV I E CUS TOMER Po ITEM STATUS KEY REM KEY 1308571 3041192-02 MARK B llacFmrdcr SK School D Discontinued; hem no longer availahle NC NoCharge HIP TO INV I AT P X 1 Special Schein Pree Goods M M;mu[acturer will ship Item directly to you 181 1/27 7 1 1' J)"eriptiun Drug: Return Awhoriration Required R Rehigcnuud ltum: Muy he shipped separately PAGE# S- Special Scbcin pricing U TcmporT ly tmacailahle: please reorder 53.90 1 OF 1 T- Tazahle ltmm WHSIr DEA# Fed 1D: 1 1-3136595 tg t�•�:. r WON i,. *1 a+3..1�' Y`� n ffi x .des 6 .s :mx. his order ias been processed by our NORTHEAS D.C. 41 WEAVEZ ROAD DENVER, A 17S L7 %IARX 1 120 -7469 EA SHARPS CONTAINER RED 1GAT, 40 40 C 3.92 156.80 1 HIS PRCDucr IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY, F YOU ARE 1 ARTICIPATING IN A DISCOUNT PROD (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE ARNED A CREDI TOWARD GOODS ='CR S RVICES; RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECET ING OR WILL R CEIVE OTTCE OF TIE DISCOUNT VALUE. FROM TIME TO TI IF, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT %GATNSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THSE RECORDS. MERCHANDI E TOTAL 156 -80 INVOI E TOTAL 156.80 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 156.80 RILL TO INVO TCE11 CUSTO PO# ITEM STATUS KEY REM, KFY 1308571 5407220 -01 MARK rs llackordcred:hemwiofunew SK SchoolKh HIP INV i E DATE g Nscontinued: hem no Ion¢cr available NC No Charge F Special Schcin FrecGoods M Manufacturer will ship ]tem directly to you 18 1/25/10 1 P Prescription Drug; Return AuihunrvioR Required R Refrigerated Item: A1ay be shipped separately INVOICE TOTAL PA(,Fff 5 Special Schein Pricing U Temporarily unavailable: plc= reorder 156.80 1 OF 2 T Taxable lwm Conllnued on Next Page WHSE DEA# Fed ID: l 1-3136595 m his order as been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, FA 175L7 1 326 -0431 EA BURN SHEETS STERILE 36 36 C 3.37 121.32 3 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 2 602 -8100 EA COLLAR AD STIFNECK SELECT UNV 50 50 C 5.75 287.50 4 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 20 20 C 8.75 175.00 6 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 4 120 -8808 EA COMBITUBE ROLL -UP KIT 41FR 8 8 41.50 332.00 7 5 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 100 100 4.80 460.00 9 6 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 80 60 4.75 380.00 7 7 890 -6868 3 /PK LIFEPAK 12 PAPER EKG 12 12 11.04 132.48 7 F YOU ARE 3 ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER SPECIAL AW DS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES, UPOq DISCOUNT RECEIPT OR REDEMPTION, OU ARE PECEIIvINC OR WILL RECEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR THEIR PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, t D UPON ANY S CH BILL T 0 CUSTOMER PC# ITEM STATUS KEY REM KEY 1308571 4901191-01 MARK n nackordered: Item will t'olluw SK School Kit D- Dis continued:liemnolongeraeailable KC NoCharge SHIP TO INVOICE T F I Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 1/22/10 9 1' Prescription Drug: Reutrn Authorization Required R Refrigerated Item: May he shipped separately Special Schein hricina U 7empnrarily unaeailablc: please reorder 1908.30 1 OF 2 T Taxahle Item Continued on Next Page SHIP TO: Matri Medal 540 W Carmel Fire Department MI INVOIC E Station 3 46 S Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 010000130857104901191110010000001908300122103 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 1908.30 INVOICE INVOICE DATE 4901191 -01 1/22/10 CUSTOMER PO SHIP TO MARK 1817102 please detach here and mail the ahove with yourpaymCni WHSE DEA# Fed ID: I 1- 3136595 4� E 0 y R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSl THE PURCHASEX THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 1908.30 INVOT E TOTAL 1908.30 PLEASE PAY WITHIN THIRTY(3 DAYS OF RE EIPT OF THIS NVOICE. 1908.30 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHE14 INC. DEPT CH 102 1 ALATINE, I 60055 -0241 BI TO CUSTOMER PO# ITEM STATUS KEY REM KEY 1308 4901191 MARK Ii Itackordered: hem will loll— SK Schoo] Kn 17 Uiwontit�ued: Item no Imeger available NC- No Charge SHIP To INVOICE QA TE 0 OF BOXES P- Special Schein Free Goods M Mamn`1Clarer will ship Item directly to you 181 1/22/ 9 1 Prescription Drug: Return Authorization Rcyuired R Refriccrated hem: May be shipped separately INVOICE TOTAL Special Schein Pricing U Temporarily unavaileblo: please reorder 1908 .3 0 2 OF 2 T- Taxahle Itcm ENVY S HEIN y FT ERMS OF ALE Matrx Medical '_vVe make eve" a r�ffz to mac Main prices for the duration w a a 7 I Payment by CHECK or by th HENRY SCHEIN CREDIT CARD, v�ever catalog, ho rae resewe the rigl nt to make price adjuslnnents in VISA. MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price clianges Guaranteed Satisfaction: If you have tried a xoduct and E', !s uefective or does not or pe0orm Bill z`o our 0 4 r e ou r Open 9cC:air satisfactorily, we Milli provide a credit, refund, or exchange; its your c rr S A�1ailaute f0 license pCaCiiil ne's In the U.S, All invoices are choice. Simp;4 cal our cu tourer sePVi i u .partrnent 4:t hlr, 30 c[ay payable wi'hin 30 day s, of receipt cf the merchandise to arrange for the return. For a u:tarraniy repair or if you vrere sent something you dim not order, smpl;�cats: Rx Products Controlled Substances, Matra Medical 1- 800 845 -3550 Ber [atons requ ra us to limit 41he sale of Bx anti controlled su^ stances only to registered, licensees healthcare professionals. li you are a neiv custorner or have recently moved, please furnish us €,vith a copy of your updated state registration. For controlled su stances, furnish a copy of your DEA certificate, verilving your shipping address. Cass II drugs can be ordere- only b1i mail. International Orders: Mlease Note: Ale nroAly serve healthcare profeSS and aovemme :,s Opened hanc.pi and equipment may not he returned for 1hroufj1hout the world. orld. To »lave orders or for IngUir e5 on export -P, h!, l wi be r c;paired or Imp*ed in @i cnrdan e vi th t- a n an' condo dons, »,ease or i'a� our li itemationa; D parts ent: ry manufacturer warranties. Before opening handpieces or 1- 830.845 -3550 equipment, ySre suggest 'that you check the shipping container and -,ac King list to verify that ou have received exactly °yh,at Prescription Drug Returns Instructions: you ordered.Opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all Prescripfion drugs. Simply call our Customer Service Deparrnew 5' -30 845 -3550, LP300 WHSE DEA# Fed ID: 11- 3136595 This order ias been processed by our NORTHEAS 'D.C. 41 WEAVER ROAD DENVER, 3A 1751.7 RK 317-57L-2663 1 499 -2923 10 /CA GRAHAM MEGA MOVER 1500 1 1 C 177.23 177.23 1 HIS PRODUCP IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIOE CENTER. ASE GOOD =M, MAY BE SHIPPED SEPARATELY. 2 677 -3721 EA BRASS OXYGEN REGULATOR 1 DISS 2 1 61.82 61.82 2 ARTIAL SHI MENT WILL SHIP AND INVOICE WHEN AVAILA LE. HIS PRO DUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. OUR ORDER 76318142 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS WHEN THEY ARE HIPPED. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR O HER PECIAL AWA DS "DISCOUNT 't)), WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOZ DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE NOTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINS7 THE PURCHASE THAT ARMED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. BILL TQ INVOICER T MER PQ# ITEM STATUS KEY REM KEY 1308571 4901131-01 MARK B Backordemd: item will follow SK -School Kit D Disconvr ued; Item no longer available NC -No Charge S HIP TO INVOICE DATE OF 50KrG F- Special Schein Frew Goods M Manufacturer will ship Item directly to you 1308572 1/22/10 2 P Prescription Drug: Return Authodmion Required R Refrigerated Item: May be shipped separately TYVQT('7 TOTAL Special Schein Pricing U Temporarily unavailable; pleas: reorder 2 3 9. 0 5 1 OF 2 T- Taxable hem Continued on Next Page WHSE DEA# Fed ID: 11- 3136595 MERCHANDISE TOTAL 239.05 INVOICE TOTAL 239.05 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 239.05 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEIq INC. DEPT CH 10211 ALATINE, 11 60055 -0241 BILL T INV E MER poft ITEM STATUS KEY REM KEY 1308571 4901131-01 MARK B Backurdered: Item will fldhtw SK School Kit Discontinued: Item no longur available NC M, C'haree SHTF TO INVOICE D ATE F BOXES I i Special Schein free. Goods M Manufacturer will ship Lem directly to you 1308572 1/22/10 2 P- Prescription Drag: Rcturn Authorization Required R Refrieuratcd Item: May he shipped separately -Special Schein Pricing U -Tent porai it y unavailable: please reorder 239.05 2 OF 2 'r -'raxable lie. VOUCHER NO. WARRANT NO, ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $2,358.05 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 4901131 -01 102 670.06 $239.05 I hereby certify that the attached invoice(s), or 1120 5407220 -01 102 390.11 $156.80 bill(s) is (are) true and correct and that the 1120 3001192 -02 102- 390.11 $53.90 materials or services itemized thereon for 1120 4901191 -01 102- 390.11 $1,908.30 which charge is made were ordered and received except y- FFR 2099 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts I 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)) 4901131-01 $239.05 5407220 -01 $156.80 3001192 -02 $53.90 4901191-01 $1,908.30 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 Cleric- Treasurer