HomeMy WebLinkAbout189821 09/14/2010 a- CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $91.70
PALATINE IL 60055 -0241
CHECK NUMBER: 189821
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 2791533 -02 91.70 SPECIAL DEPT SUPPLIES
HS ORDER# ORDER DATE
83737392 08/16/10
WHSE DEA# RHO162494 Fed ID: 1 1-3136595
r
This order has been processed by our MIDWEST D.C.
5315 WES 74TH TREET
INDIANAP LIS,IN 46268
MIDWEST D.C. State Lic##: 23 00304
RK 317 -57 -2663
1 890 -0044 6RLS /BX CURITY CLEAR ADH TAPE 2 "X10YD 14 14 6.55 91.70 1
LEASE NOTE 8903950 IS NOW 8900044
F YOU ARE 1 ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
SPECIAL AWA DS "DISCOUNT WITH THIS PURL SE YOU HAVE RNED A CREDI TOWARD
GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM
RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECET OR WILL R CEIVE
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 SITCH
EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT %GAINSl THE PURCHASEs THAT
ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RE RDS.
N HENRY CHEW, INC. HAS PURCHASED THE SPE IFIC U= OF THE PRESCRIPT ON DRUG
DIRECTLY F OM THE MANUFACTURER-
MERCHANDI E TOTAL 91.70
INVOI E TOTAL 91.70
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 91.70
a TTIII TO SHIP TO imick# MV010E TOTAL ITEM STATUS KEY REM KEY
1308571 1817102 2791533 -02 91.70 n- liackordered: lien will l'ollnr SR SchoolKit
HSI OR DER# ORDER DATE F 8 E 1) Disconlinuod: Iteni Ito longer uvuileh]e NC Nn Charge
h Special Schein lice Goods
Ni Manul'acmror will ship hem directly m you
83737392 08/16/10 8/23/10 1 1'- Prescdpiiunl .xue:RemrnAwhonzaunnRequired
T MER P PA E R Rcl6geralcd Ilcnl: May Inc shipped wpuaiely
-Special Schein Pricing
MARK 1 OF 2 I'- 'Inrial lc Idly una vuilahle: please ranrdcr
U l art amr
cm Continued on Next Rage
VOUCHER NO. WARRANT NO.
ALLOWED 20
Henn:- Schein
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$91.70
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 2791533 -02 102 390.11 $91.70 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
EP 13 2010
Ap
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))
2791533 -02 $91.70
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