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HomeMy WebLinkAbout185774 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,811.04 PALATINE IL 60055 -0241 CHECK NUMBER: 185774 CHECK DATE: 5/26/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467006 4835163 -02 75.05 EMS EQUIP 102 4239011 5034021 -01 1,023.00 SPECIAL DEPT SUPPLIES 102 4467006 5163486 -01 712.99 EMS EQUIP BSI ORDER41 ORDER DATE 81004594 05/06/10 VJHSE DEA# RH0236667 Fed ID: 11- 3136595 This order as been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751-7 NORTHEAST D.C. State Lic 3:0046 1 827 =2329 EA SUCTION UNIT W /DISP CANN 1 1 C 712.99 712.99 .1 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. F YOU ARE PARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR 0 HER PECIAL AWA DS "DISCOUNT WITH THIS PURC SE YOU HAVE PARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO q DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL R ICE IVE .14CTICE OF TIE DISCOUNT VALUE. FROM TINIR TO TIME, MED CARE, MEDICAID, TAI ARF.OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT IGAINSI THE PURCHASE THAT ARNED.SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 712.99 INVOI E TOTAL 712.99 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 712.99 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI4 INC. DEPT CH 10211 PALATINE, T 60055 -0241 BILL TO SHTP TO INVOICEn INVOICE TOTAL ITEM STATUS KEY REM KEY 1308571 1308572 5163486 -01 712.99 B- llacxordered: lrem will rollow SK- SchoolKir D I)iscomimted: Item no longer available NC No Charge I R E ORDER DA INVOICE E 1 Special Schttin Pme Of d' M Manuracturer will chip Isom directly m y ou 81004594 05/06/10 5/ 0 6/ 10 1 P- Prescription Prue: Rewrn Aurhoriration Required R Rcrripcmred llem: May be shipped separately CUSTOMER Poll PAGE# Spacial Schein Pricing U Temporarily muvailnhle: please reorder MARK 1 OF 1 T Taxahle Item pavalent f ernes: t?ye make every etfort to maintain prices for the duration o` 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: or If you have tried a product and it is detective or does not perform B ill Your Order T Yo Open Acco satisfactorily, we wil` provide a credit, refund, or exchange its your Available to licensed practitioners in the U.S. All invoices are choice. Simply cal! cur customer service department within 30 days payable within 30 days. of receipt of the merchandise to arrange for the return. For a warranty repair or if you t.ere sent something you did not order, simply call: Rx Products Controlled Substances: iatrx Medical 1- 300 -845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered licensed healthcare professionals. !t 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 I)E certificate verifying your shipping address. Class ii drugs can be ordered only by mail. International Orders: Pleas No te,, We proudly serve healthcare professionals and governments Opened handpieces and 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 International Department: manufacturer warranties. Before opening handpieces or 1-800 -845 -31550 equipment, we suggest that you check the shipping container and packing list to verify that you have received exactly what 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 1 -8;;0- 845 35;50. cx:. it w�� �`k%.� q s �i d �s_.. y: a .t r LP300 HSI CRDER# ORDER DATE 80698527 04/26/10 WHSE DEA# RH0236667 Fed ID: 11-3136595 b o his order has been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, FA 175L7 NORTHEAST D.C. State Lic 3:0046 1 499 -0776 .5 /PK OXYGEN GASKET METAL 19 19 3.95 75.05 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THERE PAYER MAY REQUEST ?NFORNATIQN REGARDING SUCH_:V UR, D,-UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT \GAINSU THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDISE TOTAL 75.05 INVOI E TOTAL 75.05 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 75.05 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following address: ENRY SCHE14 INC. D EPT CH 102,1 ALATINE, I 60055 -0241 BIL TO Hip T IFV i E0 TNV r C E TOTAL ITEM STATUS KEY REM KEY 130/8571 1308572 4835163 -02 75.05 I]- Ilackndemd: Item 'ill lo0ow SK SchoolKi NV A XE I) Di conlmued: llem no longer available NC No Charge JJSJ RD F Special Schem 1 -mo (nods M Manufacturer will ship Item directly to you 80698527 04/26/10 5/13/10 1 P- Precciiplion Drug: Rcwrn Aulhnriiation Hey aired k Refrigerated Item: Nlay he shipped suparalely special Schein Pricing U Temporarily unaNailahle; plcHsc murder MARK 1 OF 1 T- Taxable l lcm eaymenlr germs: We 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: or If you have tried a product and it is detective or does not perform ill Y o u r order To Your Op ot satisfactorily, we will provide a credit, refund, or exchange; ifs your Available to licensed practitioners in the U.S. All invoices are choice. Simply call our customer service department within 3G days a able r °�ithin 30 days. of receipt of the merchandise to arrange for the return. For a p warranty repair or it you were sent something you did not order simply call: Rx Products Controlled Substances: Matrx Medical 1 845 3550 Regulations require us to limit the sale of Rx and controlled substances only to registered licensed healthcare professionals. It 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 DISK certificate, verifying your shipping address. Glass 13 drugs can be ordered only by mail. International Orders: Please Not iec We proudly serve healthcare professionals and governments Openers handpieces and equipment may not be returned for throughout the W=orld. To place orders or for inquiries on export credit, but will be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties. Before opening handpieces or 1 80 ©E 5 3550 equipment. we suggest that you check the shipping container and packing list to verity that you have received exactly what 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 1- 800 -845 -3550. d LP300 HSI ORDER# ORDER DATE 81002180 05/06/10 WHSE DEA# RH0236667 Fed ID: 11-3136595 „M b as n :w This order ias been processed by our NORTHEAS D.C. 41 WEAVE ROAD DENVER, A 175 7 NORTHEAST D.C. State Lic 3:0046 Z _507 -8362 100 /BX NACL PREFILL SYRINGE 10ML ST 3 3 45.00 135.00 11 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 14N PEDIGR E ITEM. DC: 6380701 010 2 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 120 120 C 4.65 558.00 6 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTION CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 20 20 C 8.25 165.00 8 HIS PRODUCP IS BEING SHIPPED FROM OUR MIDWESP DISTR BUTIO CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 4 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 20 20 C 8.25 165.00 10 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTION CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER SPECIAL AWA DS "DISCOUNT ")1, WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S ERVICES, RECEIVABLE OR REDEEMABLE N ACCO ZDANCE WITH DISCOUNT PROGRAM RULES. UPOZ DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECET ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH EILL TO SHIP TO INV O [Cg# INVOICE L ITEM STATUS KEY REM KEY 1308571 1817102 5034021 -01 1023.00 n Backordcred:Itemwinronow SK SchoolKit D Discontinued: ILvm no longer available NC No Charge H E DATE 4 OF BOXES P- Special Schein Free Goods M Manufacturer will ship Item directly m you 81002180 05/06/10 5/ 0 6/ 1 0 11 P- Prescription Drug: Retum Authorization Required R Rcfrigeraied Itcm: May be shipped separately Special Scheiu Pricing IRK U Temporarily nnacailable: please reorder 1 OF 2 T- TaKahle Item Continued on Next Page HENRY CHE N SHIP TO: Matrx Medical I w Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 l'V`. 540 w 136 St Station 46 Michael Kaufmann Carmel,IN 46032 -8806 01, 000013085710503402111001000000 ],023000506103 BILL To: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic SCI BILL TO I SHIP TO I INVOICE TOTAL Carmel, IN 46032 -7543 1308571 1817102 1023.00 INVOICE INVOICE DATE 5034021 -01 5/06/10 CUSTOMER PO# MARK Plert_ce detach hero and mail the above with your payment HSI ORDER# ORDER DATE 81002180 05106110 WHSEDEA# RH0236667 Fed ID 11- 3136595 A K� :a a a a �a4+ R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSl THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN TH SE RECORDS. N HENRY 3CHEIN, INC. HAS PURCHASED THE SPE IFIC UNIT OF THE PRESCRIPT ON DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 1023.00 INVOI E TOTAL 1023.00 PLEASE PAY WITHIN THIRTY (3 DAYS OF RECEIPT OF THIS NVOICE. 1023.00 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEIJ INC. DEPT CH 10211 ALATINF, I 5005_ -7241 BILL T TNVOTCE# Th[VOTCE TOTAL ITEM STATUS KEY REM KEY 1308571 1817102 5034021 -01 1023 -00 I Dackordcrcd:ltemwillFollow 5 1� K- SchoolKil E BO D Discontinued: lwrn no lonecr available C No Charge F Special Schein Free Goods M Manufacmicr will ship Item dimctly to von 81002180 05/06/10 5 0 6 10 11 P prc.,cdplion Mug; Rcturn Aulhurixmion Required R RefrieeralA hem: May he shipped .ccparately 5 Special Schein Pricing MARK 2 2 U Tumporarity unavailable: please reorder T Taxahle Itcm HENRY SCHEI 7 T ERM S A UL w 4've make every e #fort to maintain prices for the duration o; a Payment by CHECK or by the HENRY SCHE {N CREDIT CARD, catalog, however, we reserve the right to make price adjustn:lents in VISA, MASTERCARD, ISCOVER and Afv1ERfCAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: or If you have tried a product and it is defective or does not perform Bill Your Order To Yell' Opera ,cunt sa iafactorily, vve vvill provide a credit, refund, or exchange; Its your Available to licensed practitioners in the U.S. All invoices are choice. Simpiv call our customer service department within 30 days payable Yvithin 3 0 days. of receipt of the merchandise to arrange for the return. For a warranty repair or if you were sent sormething you did not order, simply call: Fix Products Controlled Substances; l atrx Medical 1-800 -845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered, licensed healthcare protessiona'.s. 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 t ?FA certificate verifying your shipping address. Class iI druas can be ordered only by mail, International Orders: Please Note We proudly serve hea profess and u0'JErn(tlent5 Opened handpieces and equipment may not be returned far throughout the world. To place orders or for inquiries on export credit, but vvili be repaired ore laced In ac; ordance with t: p p terms and COn(titionS. pluaSe Gonfacf Ol1Y InteYr ©r'�I C�eparfm�nE. manufacturer viarranties. Before opening handpieces or t 80r7 £t 355rJ equipment, we suggest that you check the shipping container and asking list to verify that you have received exactly vtil�af prescription Drug Returns Instructions: ,ou ordered,Opened Computer Software is not returnable. Ether restrictions may also apply. t Required Q r n_ y ca l A Return Authorization is R„q�i €red for all Presc Drugs. Simply call our Customer Service Department iW' -8n0 -845 -3550. LP300 VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,811.04 ON ACCOUNT OF APPROPRIATION FOR Carmel_ Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 5034021 -01 102 390.11 $1,023.00 1 hereby certify that the attached invoice(s), or 1 120 4835163 -02 102 670.06 $75.05 bill(s) is (are) true and correct and that the 1120 5163486 -01 1 102- 670.06 $712.99 materials or services itemized thereon for which charge is made were ordered and received except MAY Z 4 2010 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)) 5034021 -01 $1,023.00 4835163 -02 $75.05 5163486 -01 $712.99 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