HomeMy WebLinkAbout196816 04/26/2011 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $169.00
CARMEL, INDIANA 46032 DEPT CH 10241
PALATINE IL 60055 -0241 CHECK NUMBER: 196816
CHECK DATE: 4/26/2011
DEPARTM ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 .4239011 8497600 -01 169.00 SPECIAL DEPT SUPPLIES
HST. ORDER ORDER DATE DUE DATE
89836748 03/29/11 05/05/11
WHSE DEA# RHO162494 Fed ID:- 11- 3136595
1 116 -0999 EA DISPENSER F /EMESIS BAG 1 1 45.00 45.00
PRODUCT IS 3EING SHIPPED.TO YOU DIRECTLY FROM THE MAZUFACTLRER.
2 116 -1000 144 /BX EMESIS BAG;1000ML BLUE 1 1 124.00 124.00
PRODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE FACT RER..
IF :YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER
PECIAL AWA ZDS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD
GOODS OR SERVICES, RECEIVABLE.OR'REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM
RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E— MED CARE,. EDICAID,.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 COUNT GAINS THEPURCHASES THAT
EARNED SUCH VALUE, ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS.
MERCHANDI E TOTAL 169.00
INVOI E TOTAL 169.00
nvoice Date 30 days 169.00
LEASE NOTE NEW REMIT TO ADDRESS
Please remi payments only to the following a dress:
ENRY SCHEI INC(
EPT CH 102 1
>N
ALATINE; I ;60055 =0241:
BTLL. TO TNVOTC INVOTCE TOTAL ITEM STATUS KEY REM KEY
1 1308571 1308572 8497600 -01 169.00 Il liaekord —dl lien) will follow SK School Kil
HSI Q Rr)ER# RDER A INVOICE DATE 4 OF BOXES 1) Disnmlinued: Item no longer available NC No Charge
F- Special Schcin Free Goods
V7 Manufacturer will ship Ilan dimclly to you
89836748 03/29/11 4/05/11 I' prescription Drug; Return Authorization Required
CUS TOMRR R Refrigerated Itcm, May he tihipped separately
Special Schcin Pricing
U Temporarily unavailable: plcasu reorder
MARK 1 OF 1 T Taxable lmm
rayfIEC161, Vl111zt.
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:
If you have tried a product and it is defective or does not perform or
satisfactorily, we will provide a credit, refund, or exchange; its your ill Your Order To Your Open Account
choice. Simply call our customer service department within 30 days Available to licensed practitioners in the U.S. All invoices are
of receipt of the merchandise to arrange for the return. For a payable within 30 days.
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 fax and controlled
substances only to registered, licensed healthcare professionals.
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 DEA certificate, verifying your
shipping address. Class II drugs can be ordered only by mail.
International Orders:
P lease Note:
Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governments
credit, but will be repaired or replaced in accordance with throughout the world. To place orders or for inquiries on export
manufacturer warranties. Before opening handpieces or terms and conditions, please contact our International Department:
equipment, we suggest that you check the shipping container 1- 800 845,3550
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 -800- 845 -3550.
v
LP300
VOUCHER NO. WARRANT NO,
ALLOWED 20
Henry Schein
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$169.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 I 8497600 -01 1 102- 390.11 I $169.00 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
APR 2 2 2011
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 N (or note attached invoice(s) or bill(s))
8497600 -01 $169.00
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