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HomeMy WebLinkAbout183319 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $2,347.20 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 183319 CHECK DATE: 3/16/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 4115691 -01 42.00 SPECIAL DEPT SUPPLIES 102 4239011 4901132 -01 227.12 SPECIAL DEPT SUPPLIES 102 4239011 7480350 -01 1,170.48 SPECIAL DEPT SUPPLIES 102 4467006 7480350 -01 907.60 EMS EQUIP WHSE DEA# Fed ID: 11-3136595 wrom M lA R rte., F YOU ARE PARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, 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 DISCOUNT AGAINSq THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. N HENRY 3CHEIN, INC. HAS PURCHASED THE SPE TFTC Uq1T OF THE PRESCRIPT ON DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL: 20 INVOI (E TOTAL 2078.08 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 2078.08 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SC14EIq INC. DEPT CH 1,0211 PALATINE, I 60055 -0241 BILL To I I livoTc CUSTOM J10V ITEM STATUS KEY REM KEY 1 7 4 80 3 5 0- 0 1 MARK 11 Backordered: Item will follow SK School Kit D Discontinued: Item no longer availahlc NC No Chargc F BOXES I' Spatial Schein Pree Goods NI Manufacturer will chip Item dircctly to you 1817102 2/23/ 1 1 0 1' Pnescription Drug: Retum Amhuri -tion Rcyuimd R Relrigerated Item: May be shipped separately E Special Schein 1'ricing U Temporarily unavailable: please reorder 2078.08 2 OF 2 T Ta.rahleItem LP300 Payrrient Terms, make every effort to maintain prices for the duration of a payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS' response to manufacturers' price changes Guaranteed Satisfaction: If you have tried a product and it is defective or does not perform or satisfactorily, we will provide a credit, refund, or exchange; its your B ill Your Order To Your Open Account choice. Simply call our customer service department within 30 clays Avai to licensed practitioners in the US, All invoices are of receipt of the merchandise to arrange for the return, For a payable vvilhin 30 days. vvarranty repair or if you were sent something you did not order simply call: Rx Products Controlled Substances: Matrx Medical 1 -800- 845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered, licensed healthcare professionals. If you are a new customer or have recently moved, please furnish us with a copy of your updated state registration, For controlled substances, furnish a copy of your D A certificate verifying your shipping address. Class 11 drugs can be ordered only by mall. International Orders: P lease Note: Opened handpieres and equipment may not be returned for Frye proudly serve healftare professionals and governments credit, d h �k' i e repaired or replaced a not be with throughout the world. To place orders or for inquiries on export terms any conditions, please contact our International Department manufacturer ,,a Before opening handp aces or 1-800-845-3550 equipment, :are suggest that you check the shipping container and packing list to verity that you have received exactly ,vhat Prescription Drug Returns Instructions: you ordered.Opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all Prescription Drugs. Simply call our Customer Service Department `a, 1-800 -845 -3050. k WHSE DEA# Fed ID: 11- 3136595 ra. a s s T his order las been processed by our NORTHEAS D. C. 41 WEAVEZ ROAD DENVER, A 175L7 1 499 -0467 EA MATRX GLOVE CADDY 2 2 21.00 42.00 1 F YOU ARE DARTICTPATTNG IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES, UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, 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 AGAINS7 THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 42.00 INVOI E TOTAL 42.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 42.00 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102 1 ALATINE, I 60055 -0241 BTrIL TO INVOICE INVOIC CUSTOMEP PO# ITEM STATUS KEY REM KEY 1308571 411 6 91- O l MARK B Hadordered: Item will follow SK School Kit HIP T INVOICE RTE F B XE 1) Discontinued_ item no longer available NC Charge F- Special Schcin Prce Crcwds M Manuladtumr will ship Item directly to you 1308572 2/23/10 1 P I)rescription thug: Return Authorirtninn Required R Refrigerated Item: May be shipped separately SpcOul Schcin Pncine 0 Temporarily unarailablo: picasc reorder 42.00 1 OF 1 T TaxableItdm Payment T We make evert effort to maintain, prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARO, cataloo, ho,vever, vie reserve the right to make price adjus ments in VISA, AIASTERCARQ, DISCOVER and AVER #CAhf EXPRESS' responsj to manufactu °ere' price changes Guaranteed Satisfaction: or If you have tried a product and it is detective or does not perform B ill Y urr Order To Y owl Open Account sat sfactorily, viev,:T provide a credit, refund, or exchange. it'S your choice, S €r3 +tali our customer service de artrnEnt within 3v days Available to licensed pract tioners in the US. All invoices are p P Y payable 4M!hin 30 days, of receipt of the merchandise to arrange for the return. For a v,arranty re ,air Qr if you °ilere sent something you did not order simply call: Rx Products Controlled Substances: atrx Medical 800 845 -3550 Regulations require us to limit the sale of Rx anti cantrofled substances only to registered, licensed healthcare professionals. if you are a nev customer or have recently moved, please furnish us vrith a copy of your updated state registration, For co!ttroiled substances, furnish a copy of your DEA certificate, verifying your shipping address. Class II drugs can be ordered only by mail. International Orders: Please N Opened handt l£GeS and e ©u prnent may not be returned fCr VVe pm -Udty serve healihcare profess onals and gGverT'iRIew nevi °,but ,�`M be repaired or replaced in accordance 01h throughout the 'e:t3ria. To place orders or far inqutnes on export manufacturer array tie;. Before opening handpi ces or terms and conditions, please contact our International Department: equipment. We suggest that you check the shipping container 1 355rJ and pacKJng list to verify that you have received exactly lv�hat Prescription Drug Returns Instructions: you ordnred.Opened Computer Software is not returnable. Other restrictions may also apply. A Return, .Authorization is Required for all Prescripticn Drugs. Simply cal our C stomer Service Department LP300 WHSE DEA# RH0236667 Fed ID: 11- 3136595 ON M .r ARK 317-57L-2663 1 499 -0650 EA BREATHSAVER ULTRA ROYBLUE 1 1 227.12 227.12 2 499 -3262 EA ULTRA BREATHSAVER "D" BAG RED 1 B 0.00 0.00 I TEM BACK 0 DERED, WILL FOLLOW SHORTLY P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE FACT RER. OUR ORDER 76318142 HAS BEEN SPLIT INTO MULTIPLE SHI MENTS. CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE TEMS HEN THEY ARE HIPPED. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR 0 HER PECIAL_ AWA DS "DISCOUNT WITH THIS PURC SE YOU HAVE ARMED A CREDI T04dARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOF DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF THE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, 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 DI COUNT GAINS THE PURCHASE THAT E ARNED SUCH VALUE, ACCORDINGLY, YOU SHOULD RE AIN TH SE RE ORDS- MERCHANDI E TOTAL 227.12 INVOI E TOTAL 227.12 PLEASE PAY WITHIN THIR7Y(3 DAYS OF RECEIPT OF THIS NVOICE. 227.12 B LL TO INV Z E CU mEa ITEM STATUS KEY REM KEY 1308571 4901132-01 MARK h Backordered: hem will follow SK School Kit D Di. nminucdl hem no longer acadahle NC No Charge P T E TE F 1' Special Schuin Frcc d, M Manulacturcr will ship Item directly to you 13 0 5 5 7 2 2/26/10 11 Prescription Drug: Return Authorisation Rquired R Refrigerated Item; May he stripped separately INVOI TQTAL PAGE# Special Schcin Pricing U Tetnperarily unavailable: please. reorder 227.12 1 OF 2 T Taxablcltcm Continued on Next Page FA H ENRY CHEIN i cal SHIP TO: Carmel Fire Department MI INVOICE Station Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 01 00001 308571074803501100 ],0000002078080223105 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 EILL To INVOICE TOTAL 1308571 2078.:08 INVOICEO INVOICE DATE 7480350 -01 2/23/10 CUSTOMER P0# SHIP TO MARK 1817102 WHSE DEA# Fed ID: 1 1- 3136595 This order ias been processed by our NORTHEAS D.C. 41 WEAVEZ ROAD DENVER, 3 A 1751-7 382276 00 /CA EXTE SION SET STD BORE UL CGAW B. B UN MEDICAL INC. 473444 1 338 -2276 PU 100 /CA EXTENSION SET STD BORE UL 4 4 C 226.90 907.60 4 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. ,/2 891 -3037. U 50 /CA IV PREP KIT W/ TEGADERM 4 4 C 61.97 247.88 8 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIOE CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. SOS -8362 100 /BX NACL PREFILL SYRINGE 10ML ST 2 2 45.00 90.00 10 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. N PEDIGR E ITEM. DC:6380701 010 -/4 555 -5396 PU EA PROTECTIV ACUVNC SFT CATH 20X1.25 200 200 C 2.71 542.00 9 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES CISTR:BUTIOI CENTER, ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. t .'S 555 -1166 ITJ EA PROTECTIV ACUVNC SFT CATH 18X1.25 100 100 2.71 271.00 10 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 16 996 -2369 100 /13X LANCET SURGILANCE ORANGE 21G 2 2 9.80 19.60 10 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 13ILL 10 INVOIC CUSTOMER POR ITEM STATUS KEY REM KFY 1308571 7480350 -01 MARK N- liackordercd: Item will lull— SK SchadKit HI NV I D I)iu:ontinurd: Elcm no longer aeailahlc NC No Charge P Fpecial Schein Pre; Goods M Manufacturer u9ll ship item directly io you 1817102 2/23/10 10 P- Presc'riptiml Onig: RCIUM Authorization Required K Relrigerated Item: May he shipped separately INVOIC TOTAL PAQE# Special Scheill lhicing U Temporarily unavailahle; please rcorder 2078 08 1 OF 2 T- Tarahle lien, Continued on Next Page L VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $2,347.20 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 4901132 -01 102 390.11 $227.12 1 hereby certify that the attached invoice(s), or 1120 4115691 -01 102 390.11 $42.00 bill(s) is (are) true and correct and that the 1120 7480350 -01 102- 670.06 $907.60 materials or services itemized thereon for 1120 7480350 -01 102- 390.11 $1,170.48 which charge is made were ordered and received except MAR 15 2010 f Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund i r i 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 invoices) or bill(s)) 4901132 -01 $227.12 4115691-01 $42.00 7480350 -01 $907.60 7480350 -01 $1,170.48 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