Loading...
HomeMy WebLinkAbout188838 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 0 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,895.56 PALATINE IL 60055 -0241 CHECK NUMBER: 188838 CHECK DATE: 811 812010 DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 9580743 -01 1,692.02 SPECIAL DEPT SUPPLIES 102 4239011 9729451 -01 203.54 SPECIAL DEPT SUPPLIES a HSI ORDER# ORDER DA'Z'E 83210433 07/27/10 WHSEDEA# RHO162494 Fed ID: I1- 3136595 D his order las been processed by our MIDWEST D.C. 5315 WEST 74TH 3TREET TNDIANAP LIS,IN 45268 MIDWEST D.C. State Lic 23 00304 AARK 317 -57 -2663 SAMPLES JUS FOR YOU 4995724 PINK 1 194-0093 EA VASELINE GAUZE 3 1 IX9" 48 48 0.65 31.20 1 2 499 -2550 EA EMS SHEARS BLACK 2 2 2.00 4.00 3 HIS PRODUC IS BEING SHIPPED FROM OUR NORTHE ST DIS RIBUT ON CENTER. 3 499 -57231 EA EMS SHEARS BLUE 2 2.00 4.00 3 HIS PRODUCC IS BEING SHIPPED FROM OUR NORTHEAST DIS RIBUT ON CENTER. 4 499 -5729 EA EMS SHEARS ORANGE 2 2 2.00 4.00 3 HIS PRODUCF IS BEING SHIPPED FROM OUR NORTHEAST DIS RIBUT ON CENTER. 5 499 -5726 EA EMS SHEARS RED 2 2 2.00 4.00 3 HIS PRODUCC IS BEING SHIPPED FROM OUR NORTHEIkST DIS RIBUT ON CENTER. 6 499 -5728 EA EMS SHEARS PURPLE 2 2 2.00 4.00 3 HIS PRODUC IS BEING SHIPPED FROM OUR NORTHE ST DIS RIBUT ON CENTER. 7 499-5725 EA EMS SHEARS YELLOW 2 2 2.00 4.00 3 HIS PRODUC IS BEING SHIPPED FROM OUR NORTHE ST DISTRIBUTION CENTER. 8 499 -5727 EA EMS SHEARS GREEN 2 2 2.00 4.00 3 P TO INVOICE# INVOICE: z ITEM STATUS KEY REM KEY 1308571 1308572 9729451 -01 203.54 Is- 14ackordend: Item will follow SK School Kit Discontinued: Item no longer available NC No Charge O RDER DATE INVOICF DATF 0 or pats P Special Schein 1 rce Goods M Manufacturer will ship Item directly m you 83210433 0 7/ 2 7/ 10 7/27/10 3 p- Prescription Drug: Return Authorization Required R Refrigerated Item: May he shipped separately Special Schein Pricing MARK 1 U Temporarily unavailable: please reorder OF 2 T- Taxable Item Continued on Next Page ENPY SCHEIN e SHIP TO /SOLD TO: Matrx q!V'_ Carmel Fire Dept Head Quarters MI 135 Duryea Road, Melville, NY 11747 2 civic Sq Carmel,IN 46032 -2584 "01, 000013085710972945 1110010000000203540727101, BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept M1 2 Sq SILL TO SHIP TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 1308572 203.54 INVOICE INVOICE DATE 9729451 -01 7/27110 CUSTOMER POH MARK HSI ORDER# ORDER DATE 83210433 07/27/10 WHSEDEA# RHO162494 Fed ID:11- 3136595 M L I HIS PRODUCC IS BEING SHIPPED FROM OUR NORTHEAST DISTRIBUTION CENTER. 9 499 -5724 EA EMS SHEARS PINK 2 2 0.00 0.00 3 NC HIS PRODUcr IS BEING SHIPPED FROM OUR NORTHE ST DIS RIBUT ON CENTER. 10 499 -1860 EA ULTRA SOFT BOX PLUS RED 1 1 144.34 144.34 2 HIS PRODUC IS BEING SHIPPED FROM OUR NORTHEAST DIS RIBUT ON CENTER. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR O HER PECIAL AWA S "DISCOUNT WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, 'IOU ARE RECEI ING OR WILL R CEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR I_v_FP PAYER MAY PEQCTEST INFO?MnTION REGP_RDING SUCH V ?•UE, D UPON ANY S TCH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GATNSI THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. MERCHANDI E TOTAL 203.54 INVOI E TOTAL 203.54 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 203.54 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEIi INC. DEPT CH 10211 PALATINE, 11 60055 -0241 Dift To SHIP TO NV QICE# NV TA ITEM STATUS KEY REM KEY 1308571 1308572 9729451 -01 203.54 13- l3achordered:hem will tolit— SK- School Kit D Di conlinued: Item no longer available NC No Charge HSI ORD ER4 ORDER F Special Schein Free Goods X1 Manufacturer will ship hem directly to you 83210433 0 7/ 2 7/ 10 7/27/10 3 11- Prescription Drug: Return Authorimtion Required R Refrigerated Item: May be shipped separately r1mTOMEP Poil Special Schein Pricing MARK 2 0 F 2 U Temporarily unavailable: please reorder T- T, able Item .HENRY SCHEIN T ERMS f a Pay cmeril Terns: We make every effort to maintain prices for the duration of a payment by CHECK or by the HENRY SCHEIH CREDIT CARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS Msponce to manufacturers` price changes Guaranteed Satisfaction. or If you have tried a product and it is defective or does not perform E611 Your Order To Your Owen A ccount satisfactorily, we will 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 3 days payable within 30 day& of receipt of the merchandise to arrange for the return. For a warranty repair or if you were sent something you did not order simply call: lax Products Controlled Substances: l atrx Medical 1 -800- 845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to reglste"ed, llCenssd healthcare r„ refess:onals. ;I you are a nevi customer or have recently moved, please= furnish us with a copy of your update, state registration. For controlled substances, furnish a copy Of your DcA certificate verifying your shipping address. Class it drugs can be ordered only by mail. International Orders. pi vase Note. We .ro jdly serve hea' hoare professionals and novarnnients Opened handpeces and equipment may no` be returned fo throughout the world. i o place orders or for inquiries on export !:,relit, but be repaired or replaced in accordance with terms and conditions, please contact Our Internatlo. al Depar9mar l: marr lecturer l-yareanties. Before opening handpieces or 1 80© 845 3550 equipment, we suggest tna 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. 1 MM 30; LP300 HSI ORDER# ORDER. DATE 83306239 07/29/10 WHSE DEA# RHO162494 Fed ID: 11- 3136595 r m 1 nt �,P t ��,x.� m• �v ejk�.!: his order as been processed by our MIDWEST .C. 5315 WES 74TH TREET INDIANAP L1S,I14 46268 MIDWEST D.C. State Lic 23 00304 1 900 -4500 100 1EX BANDAGE SCHEIN FLEX FABRC LF1"X3" 12 12 1.57 18.84 5 LEASE NOTE 1016187 IS NOW 9004500 2 496 -2369 100 /BX LANCET SURGILANCE ORANGE 21G 5 5 9.95 49 -75 3 3 220 -2270 1 EA THOMAS HOLDER F /ET TUBE ADULT 25 25 3.05 76 -25 3 4 499 -7629 EA ET TUBE CUFFED 7.0 30 30 1.15 34.50 3 5 220 -1652 EA COLLAR XTRIC STIFNECK CER PEDIAT 20 20 C 5 -90 118 -00 1 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 6 890 -6800 EA SHARPS SHUTTLE SINGLE USE P2 50 50 1.50 75.00 3 7 900 -4982 4QT SHARPS CONTAINER 32 32 6.99 223.66 3 8 555 -5396 PU EA PROTECTIV ACUVNC SFT CATH 20X1.25 300 300 2.74 822.00 5 9 555 -4687 PU EA PROTECTIV ACUVNC SFT OATH 22GXI" 100 100 2.74 274.00 5 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AW DS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD s To Hip 1 0 INVOICE INVO ICE4 INVOIC TO TAL ITEM STATUS KEY RF,M KEY 1308571 1817102 9580743 -01 1692-02 s B- kordered: l lem wiP rouo, Sk- Sch -1Kil D D,sconunur.d: Item vo lenger availublc NC No Charge HSIOR DER4 OMERPATF INVOICE F BOXES 1� Special Schein Free Goods M Mamitaclnrer will ,hip item direcrh w you 83306239 0 7/ 2 9/ 10 7/29/10 5 P Frescriplian Drug: RCIUra Amhonzaflon Required R ReCdecrarcd Item: May be shipped scparalcly S Special Schein Pricing U Temporarily unavailable: please reorder MARK 1 OF 2 r Taxable Ilan Continued on Next Pale HENRY SCHEIN Matrx Med i cal SHIP TO /SOLD TO: I Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 l 540 w 136 St Station 46 Michael Kaufmann Carmel,IN 46032 -8806 0100001308571095807431100 10000001x692020729104 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 INVOICE TOTAL Carmel, IN 46032 -7543 1308571 1817102 1692.02 INVOICE9 INVOICE DATE 9580743 -01 1 7/29/10 CUSTOMER PO' MARK Please detach here and mail the above with your pavment HSI ORDERk ORDER DATE 83306239 07/29/10 WHSE DEA# RHO162494 Fed ID: 11- 3136595 3 GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECET OR WILL R CEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR O THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, JPND UPON ANY SIJCH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSl THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN =ESE RECORDS. MERCHANDI E TOTAL 1692.02 INVOI E TOTAL 1692.02 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1692.02 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEII INC. EPT CH 10211 ALATINE, I 60055 -0241 BILL TO SHIP TO TNV E INV I E TOTAL ITEM STATUS KEY REM KEY 1 1308571 1817102 9580743 -01 1692.02 It Hackordered:ltemwillfollow SK ScheelKit D Discontinued: item no longer availahic i`C No Chur,c I ORT)ER# ORDER DATE INVOICE D B I`- special Schein free Goods R1 -Men ufaaurcr will ship ltcm directly ut vuu 63306239 07/29/10 7 2 9 10 5 P prescription Drug: Remrn Auxhnrirntion Regahcd R Refrigerated Item: May he shipped separamly CUSTOMER POO .10.0 S, Special Schein Pricing= MARK 2 OF U 'Temporarily Ima� iIahle: please. reorder 2 T Tamthlellem RHENRY SCHEIN" T. EIRMS OF �S ALE Matrx Medical nake ev effort to maintain prices for the dwat or. o' a I Payment by CHECK or by the HENRY SCREW CREDIT CARD, l Catalog, hmvP- ve, we reseive the righ� to make price aJjj. en"s in VISA MASTERCARD, DISCOVER and AMERICAN' EXPRESS res,—M to may utacturers'price changes VJSE# M, Guaranteed Satisfaction: I or If voill have tried; a omdud and it is defe!AiVe Di does r10 'Derflarm Bw Your Gdei T You� r 0-cn sa ;rSia, v �ev� ';T Pr01,6d& a credit, refund, or excrange Ts. you� i- Availabie fio licensed pactJioners in, *,he U S All invoices aie i 1 1 ch Sb plj call ou cusllDmer service d-epanment within 3J days ,9. payable 'vvith 3 J ays. of recz;ip N the anErchandiseto arrange for the retLvrfi. For a v, re pair or ii voti V,-ge sent sornal,ning you did not orde. SiMbj call: Rx Products Controlled Substances: Matrx Medical 1-800-845-3550 Regulations reqwre as to limit the sale of Rx and controlled su�slance8 only to reg,stered, iicensed re-01 prc'essbrlals vnl are a nevkv customer w havL ecenflv move'd, uiease t j s w a c o n y o Yo ur u p da t e' Sta I e r e ol i s r a ti o n. For Con ad suostances, furnis1h a co of your D arfificate, verifying your shipping address. Class 11 drugs can be ordered only by mail, International Orders- Pie-pse Note: Vve r serve hea'.thcare l niof-- -ssionals and erlimerfs handruieces and ea-, may nos b2 re ec 101 throughout the vvoti. To place ord-ers w for in-oUnes on exp0q bJ v�; J� ,e rena�r� Cl' eo�aced in accordarce �k,,VM terms and conditions, marlaiactikirer vva ran. fires. Before opening handpipi-es or we surces ial vou check the shiodn container and nacxjng list t.- veriiv iMat you hav re: eiveo exac% what Prescription Drug Returns Instructions: you orderzed,Opened Computer Software is not returnable. Other restrictions may also apply, A Return Authorization is Required for all P rescr 0 ri ',?Yjos. &molv ,aJ ou Customer Se rvicz Deparnen' 9 1 -800-845-35) LP300 VOUC.HER'NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,895.56 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO, ACCT #/TITLE AMOUNT Board Members 1120 9580743 -01 102 390.11 $1,692.02 1 hereby certify that the attached invoice(s), or 1120 9729451 -01 102 390.11 $203.54 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 AUG i 6 MID 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)) 9580743 -01 $1,692.02 9729451 -01 $203.54 1 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