HomeMy WebLinkAbout182863 03/03/2010 a CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
CHECK AMOUNT: $299.52
a,�Ga CARMEL, INDIANA 46032 DEPT CH 10241
o� PALATINE IL 60055 -0241 CHECK NUMBER: 182863
CHECK DATE: 3/312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467006 4901131 -02 61.82 EMS EQUIP
102 4239011 5740937 -01 237.70 SPECIAL DEPT SUPPLIES
WF-SE DEA# Fed ID: 1 1- 3136595
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his order has been processed by our MIDWEST D.C,
5315 WEST 74TH 3TREET
INDIANAP LIS,IN 46268
1
ARK 317 -51 -2663
1 677 -3721 EA BRASS OXYGEN REGULATOR 1 DISS 1 1 61.82 61.82 1
HIS PRODUCU IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIOT CENTER.
F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE REED A CREDI TOWARD
GOODS _OP_ .S. RVTCES -OR REDEEMABLE N ACCO ANCE.WI.TH_DISC`O,UNT_ PROGRAM
RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEI ING OR WILL R CEIVE
OTICE OF THE 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
R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS THE PURCHASE THAT
E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS.
MERCHANDI E TOTAL 61.82
INVOI E TOTAL 61.82
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 61.82
1.1, TO I NVOICE# CUSTO PQ# ITEM STATUS KEY REM KEY
1 3 08 5 71 490 MARK n Hackardercd; ltcm will follow 5K 5chm 10
1) I)iseontinued_ Item no longer availahle NC Vu Charge
SHIP TO INVOICE DATE OF ROXES h Special Schein Frey (;nods
M Manhlachner will ship Item directly to you
1308572 2/11/10 1 1' I'resenptioo Dlllg: Ruiura Authomation Reyuimd
R Rolriguratcd hem; May he ..hipped separately
INV OICE TOTAL E Special Schein Pricing
U Temporarily unavailable; please reorder
G1. 82 1 OF 2 T Taxable hetn Continued on Next Page
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E DEA# Fed 1D: 11-3136-595
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his order ias been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, A 1751_7
RK 317-423-8784
1 153 -2007 20 /RL BIOHAZARD BAG 14.5X19 RED 3GAL 30 30 C 2.05 61.50 3
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
2 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 20 20 C 8.81 176.20 5
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
F YOU ARE ARTICIPATING IN A DISCOUNT PROD (E.G. POIN,S, GIFTS OR 0 HER
PECTAL AWA S "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDIT TOWARD
GOODS OR SERRVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM
RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECET OR WILL RECEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRI ARE OR
D ITHER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY SITCH
EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSrl THE PURCHASE THAT
E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS.
MERCHANDI E TOTAL 237.70
INVOI (.E TOTAL 237.70
PLEASE PAY WITHIN THTRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 237.70
BILL z Irrvol ITEM STATUS KEY REM KEY
1308571 5740937 -01 MARK 13- t3ackordcwd: hem will follow SK- SehoolKit
i7 Uiuontinucd_ Item no longer available NC- N, Charge
BOXES P- Special 5chcin hlce Goods
N1 ManUlUiUrcr will shlP ILCIII dircclly In you
1817102 2/ 1 7/ 1 0 5 I'- Prescription Drug: Return Amhorizutian Required
It Refrigerated Item: Mav N shipped cepuratcly
INVOICE TOTAL R Special Schein pricing
U Temporarily unavailahle: please reorder
237.70 1 OF 2 T Taxahlc item Continued on Next Page
VOUCHER NO. WARRA N O,
Henry Schein ALLOWED 20
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$299.52
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#! Dept. INVOICE NO. ACCT #MTLE AMOUNT
Board Members
1120 4901131 -02 102- 670.06 $61.82 1 hereby certify that the attached invoice(s), or
1120 5740937 -01 102 390.11 $237.70
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
FEB 262010
d'
1,J
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))
4901131 -02 $61.82
5740937 -01 $237.70
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