HomeMy WebLinkAbout186348 09/06/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
6 ONE CIVIC SQUARE HENRY F 1
NRY SCHEIN INC CHECK AMOUNT: $3.95
D CARMEL, INDIANA 46032 PALATINE IL 60055 -0241 CHECK NUMBER: 186348
CHECK DATE: 6/912010
DEPARTMENT ACCOUNT PO NUM I NVOICE NUMBER AM OUNT DESCRIPTION
1120 4237000 4835163 -03 T 3.95 REPAIR PARTS
HSI ORDER# ORDER DATE
80698527 04/26/10
WHSE DEA# RH0181709 Fed ID: 11- 3136595 I o
his order has been processed by our WESTERN I.C.
255 VISTA BLVD
SPARKS, IJV 8943
WESTERN D.C. State Lic 23 00461
4
1 499 -0776 5 /PK OXYGEN GASKET METAL 1 1 3.95 3.95 1
HIS PRODUC IS BEING SHIPPED FROM OUR WEST COAST DI 3TRIBUI ION CENTER.
F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
PECIAL AW DS "DISCOUNT WITH THIS PURL SE YOU HAVE 12ARNED A CREDI TOWARD
GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM
RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEII-IN G OR WILL R CEIVE
170TICE OF TIE DISCOUNT VALUE. FROM TIME TO TT E, MED CARE MEDICAID, TRI ARE OR
THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH
REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI 3 3COUNT AGAINSq THE PURCHASET THAT
EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS.
MERCHANDISE TOTAL 3.95
INVOI E TOTAL 3.95
BALANCE DUE US. PLEASE ADD TO YOUR NEXT ORDER OR PAYMENT. 3.95
LEASE NOTE NEW REMIT TO ADDRESS
lease remi payments only to the following a dress:
ENRY SCHEI4 INC.
EPT CH 10211
ALATINE, I 60055 -0241
E L To slilp N I E T TAL STEM STATUS KEY REM KEY
1308571 1308572 4835163 -03 3.95 1) Backordered: Item will rolio" SK School Kit
HSI OR O RDER DATE IYVO E D I Spec al Schein I L nee Goods lon ger available NC- No Charge
M Manufacturer will .hip Item directly to you
80698527 0 4/ 2 6/ 10 5/21/10 1 P- Prescription Daig: Ketnm Authorisation Required
R Refrigerated Item: May he shipNd separately
Special Scliein Pricing
1 U- Temporarily unavailable: please morder
MA RK 1 OF
T Taxable Item
k "ate q �krl `T' `•'ri ;E -y.
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P ay m ent errx:
We make ever} 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 B ill Your Order T Your Open Account
satisfactorily, lire vjill provide a credit, refund, or exchange; it's your Available to licensed practitioners in the US, All invoices are
choice. Simply call our customer service department within 30 days payable within 30 days.
of receipt of the merchandise to arrange for the return. Fora
warranty 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
its with a copy of your updated state registration. For controlled
substances, furnish a copy of your DE certificate verifying your
shipping address. Class N drugs can be ordered only by mail,
International Orders:
P!e ;se N ote:
kNe proudly serve healthcare professionals and governments
Opened handp €eves and equipment may not be returned for throughout the on 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- 845.3550
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 cal!
our Customer Service Department d 1- 800 845 -35500
S fflmM v all 1 M
LP300
VOUCHER NO. `WARRANT NO.
ALLOWED 20
Henry Schein
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$3.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 4835163 -03 42- 370.00 $3.95 1 hereby certify that the attached invoice(s), or
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
li IAI
7
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts t City Form No. 20i (Rev. 1995)
ro
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))
4835163 -03 $3.95
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