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Home My WebLink About190298 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $693.30 CARMEL, INDIANA 46032 DEPT CH 10241 off �o PALATINE IL 60055 -0241 CHECK NUMBER: 190298 CHECK DATE: 9/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 2791534 -01 85.50 SPECIAL DEPT SUPPLIES 102 4239011 3301252 -01 462.00 SPECIAL DEPT SUPPLIES 102 4239011 6282134 -01 145.80 SPECIAL DEPT SUPPLIES HSI ORDERH ORDER DATE 84357590 09/08/10 WHSE DEA# RHO162494 Fed ID: 11- 3136595 a .m?:: ...�t 7462268 FUME �u his order as been processed by our MIDWEST .C. 5315 WES 74TH INDIANAP LIS,IN MIDWEST D.C. State Lic 23 00304 17 -571 -266 1 360 -1359 EA SAM SPLINT ORANGE /BLUE 36X4.25 20 20 6.75 135.00 1 2 857 -0650 EA BERMAN AIRWAY 50MM SZ 0 36 36 0.30 10.80 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR 0 HER PECIAL AV:A DS "DISCCUNT")), WITH THIS PURCH SE YOU HAVE ARMED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL R CEIVE OTICE OF T iE DISCOUNT VALUE. FROM TIME TO TI 1E, MED LCARE, MEDICAID, TRI 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 DI 3 3COUNT %GATNSq THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH RECORDS. MERCHANDI E TOTAL 145.80 INVOI E TOTAL 145.60 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 145.80 BI LL TO SHIP TO I NVOICE ITEM STATUS KEY REM KEY 1308571 1817102 6282134 -01 145.80 li- Backordered: hem will follow SK SchoolKit HSI P ER RDE DATE NV A F xE D Discontinued: Item no lonecr ge. F- Special 1''rc-r. Good availahlL` NC No Char MI Manufac urer will ship Item directly to you 84357590 09/08/10 9/08/10 1 P- PrescriprionDntg :ReturaAuthoriratia¢Required R Refrigerated hem: May he shipped separately S Special Schein Pricing U Tempunn unavailable: ph rcordeY MARK 1 OF 2 'r- Taaahle hom Continued on Next Page HSI ORDER# ORDER DATE 8410871 09/07/10 3 WHSEDEA# RHO162494 Fed ID: 11 -3136595 Y his order ias been processed by our MIDWEST D.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 MIDWEST D.C. State Lic 23 00304 1 507 -0791 PU EA IV EMS SET W /ULTRA SITE 8 15DROPS 300 300 C 1.54 462.00 6 ASE GOOD I FEM, MAY BE SHIPPED SEPARATELY. F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR O HER PECIAL.AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPOd DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL k CEIVE OTICE OF THE DISCOUNT VALUE. FROM TIME TO TILE, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V ),LUE, PND UPON ANY S JCH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT 2LGAINSl THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. MERCHANDIIIE TOTAL 462.00 INVOI E TOTAL 462.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 462.00 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY.SCHEI INC. DEPT CH 10211 ALATINE, I 60055 -0241 RILL TO SKIP T INV OICER INVOTCE TOTAL ITEM STATUS KEY REM KEY 1308571 1817102 3301252 -01 462.00 H- Backnrdcrcd: Lcm will follow SK SchoolKil H I RDER RD R DATE INVOICE DATE F BOXES D Discominucd: Lem no longer available NC No Charge P Special Schein Fme Goods M Manufacturer will ship Item directly to you 8 4 310 8 71 09/07/10 9 0 7 10 6 P Prescription Drug: Return Authorization Required R Refrigerated hem: A1ap he.shipped .eparatcly Special Schein [Incine U -Temporarily unavailable: pioase reorder MARK 1 OF 1 T Taxable Lem W make even e for to maintain prices for the d rration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, however, eve reserve the right to make price adjus'n,en ±sin VISA, MASTERCARD, ISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: wsa or If you have tried a product anti it is defective or does not perform off Your Order To V our Open 4�ccavrit satisfactorily, we rr1! pro'virfe a credit, refund, or exchange; its your Available to licensed practitioners in the ��.S. All invoices are choice. Sim ,ply call our sustcmer service de arlment within 30 days of receipt of the merchandise to arrange for the return. Fora payable within 35 days. Y''a €rant, repair or if you enure sent something you did not order, simply Dell: Rx Products Controlled Substances: Matrx Medical 804 -845 -3554 Reaulations require us to 5nnit the sal: of Rx and controlled su stancas only to reg €stored, licensed healthca,e prcfessianais. if ,ou are a r ei, customer or have recently moved, please furnish trs with a cope of 'your updated state registration. For controlled su'astances, furnish a copy of your DEA cenificate verifying your. shipping address. ;lass f drugs can be ordered only by mail. International Orders: Please N ote: T 0a proUdiy serve heaithcare profess orals and r ;o'. =rnn eats Opened handpieces and equipment may not be returned for fhruuahout the rvo €id. To place or lens or for inquiries on export credit, nut hill be repaired Cf re,L°llaced in accordance with terms and conditions, please Contact our lnternational Deilanrnent: manufacturer warranties. Before' opgming handpieces or equinment, we suggest that you check the shipping container and packing list to v'erif} that;tou have received exac :What Prescription Drug Returns I nstructions: voiu ordered.opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Requi red for all Prescription Drugs. Simply call DU- Customer Service Departrnen1 9 -570- 545 -355 N ,2 Z LP300 HSI ORDER# ORDER ""TE 83737392 08/16/10 WHSE DEA# RHO162494 Fed ID: 1 1- 3 136595 t a RK 317-57L-2663 1 499 -5558 24 /CA INSTANT COLD PACKS DISPOS 6 6 8.50 51.00 a 2 499 -5557 24 /CA INSTANT HEAT PACKS DISPOS 3 3 11.50 34.50 OUR ORDER 3737392 HAS BEEN SPLIT INTO MULTIPLE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE TEMS HEN THEY ARE HIPPED. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE•OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPC) DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF T fE DISCOUNT VALUE. FROM TIME TO TT 1E, MED ECARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, JAND UPON ANY STJCH EQUEST, SUM VALUE MUST BE DISCLOSED AS A DI COUNT %GAINS7 THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. N HENRY 3CHEIN, INC. HAS PURCHASED THE SPE IFIC UNIT OF THE PRESCRIPT DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 85.50 INVOI E TOTAL 85.50 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 85.50 ILL T o 114VOICE# INV I E TOTAL ITEM STATUS KEY REM KEY 1308571 1817102 2791S34-01 8 5 5 0 11 packordered: hem will louow SK School Kit ItbER E DATE INVOICE D E 1) Di COmInnCd; [rem no longer available NC No Charge I Special Schein free Good, M NlanulactPrcr will Ship Item directly to YOU 83737392 0 8 16 10 9/16/10 P llwscnpu- Drug: Return A am uri -lion Required k Refrigerated Item: May he shipped separately CUSTOM P' E S Special Schein Pricing U Temporarily tmavailahle: please reorder MARK 1 OF 2 T- Taxable Item Continued on Next Page VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $693.30 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 6282134 01 102 390.11 $145.80 1 hereby certify that the attached invoice(s) or 1120 3301252 -01 102 390.11 $462.00 bill(s) is (are) true and correct and that the 1120 2791534 -01 102- 390.11 $85.50 materials or services itemized thereon for which charge is made were ordered and received except SFP 2. 7 2010 t l 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)) 6282134 -01 $145.80 3301252 -01 $462.00 2791534 -01 $85.50 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