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Home My WebLink About166238 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $2,181.84 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 166238 CHECK DATE: 11/24/2008 DE PARTMENT ACCOUNT PO NU MBER INVO N UMBER A MOUNT DE SCRI P TION 102 4239011 2074278 -01 11.70 SPECIAL DEPT SUPPLIES 4239011 5491909 -01 2,035.64 SPECIAL DEPT SUPPLIES 102 4239011 5491909 -02 64.56 SPECIAL DEPT SUPPLIES 2.02 4239011 5491909 -03 69.94 SPECIAL DEPT SUPPLIES ks r e e r a Y r r WHSE D''"'A# Fed ID: 11- 3136595 u Y- 01; 8 k a-.x� A This order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 14ARK 317-57--2663 1 555 -1166 PU EA PROTECTIV ACUVNC SFT CATH 18X1.25 24 24 2.69 64.56 1 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURL SE YOU HAVE RNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM RULES. uPb4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY STICH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSq THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS") CREDIT CARD TO MAKE THIS DURCHASE, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCES OF T OSE BENEFITS IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. N HENRY CHEIN, INC. HAS PURCHASED THE SPECIFIC UNIT OF THE PRESCRIPT ON DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 64.56 INVOI E TOTAL 64.56 PLEASE PAY WITHIN THIRTY(3 DAYS OF RE EIPT OF THIS NVOICE. 64.56 B ILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 S491909-02 MARK B Backordered: Item will follow SK School Kit HIP T INV E DATE F B XE D Discontinued: Item no longer available NC No Charge P- Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 11/ 1 P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NITMRPP INVOICE TOTAL PAGE -special Schein Pricing U Temporarily unavailable: please reorder 114 5 2 2 0— 3 64.56 l OF 2 T- Taxable Item Continued on Next Page L WHSE EA# Fed ID: 11-3136595 k rr m�`�, This order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 RK 317-57--2663 1 555 -1166 PU EA PROTECTIV ACUVNC SFT OATH 18X1.25 26 26 2.69 69.94 1 HIS PRODUCE IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPCyq DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE 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 DISCOUNT %GAINS7 THE PURCHASEI THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. IF YOU HAVE U SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY BENEFITS F ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF T OSE BENEFITS TIVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. N HENRY CHEIN, INC. HAS PURCHASED THE SPECIFIC UqIT OF THE PRESCRIPT ON DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 69.94 INVOI E TOTAL 69.94 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 69.94 BILL Tn INVOICE# CUS TOMER Poll ITEM STATUS KEY REM KEY 1308571 5491909-03 MARK 13 Backordered: Item will follow SK School Kit HIP T INVOICE DATE F BOXES D Discontinued: Item no longer available NC No Charge P- Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 11/17/08 1 1' Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately HSI NTIM13ER INVOICE TOTAL PAGE Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 3 69.94 1 OF 2 T- Taxable hem Continued on Next Page L WHSE 0EA# Fed ID: 11-3136595 21 a This order has been processed by our NORTHEAS" D.C. 41 WEAVER ROAD DENVER, )A 175L7 VIARK 317-57-2663 1 221-3973 3/PK GLUCOBURST GLUCOSE GEL 15GM 12 12 5.25 63.00 11 THIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES' DISTRIBUTIOE CENTER. THIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES' DISTR BUTIOI� CENTER. rHIS PRODUCI IS BEING SHIPPED FROM OUR MIDWES7 DISTREBUTIO! CENTER. ITEM BACK OZDERED, WILL FOLLOW SHORTLY THIS PRODUCU IS BEING SHIPPED FROM OUR MIDWES" DISTRIBUTIOE CENTER. MN PEDIGR�E ITEM. THIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES' DISTR BUTIOI� CENTER. 7-ASE GOOD irEM, MAY BE SHIPPED SEPARATELY. THIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTR[BUTIOI� CENTER. CASE GOOD I�EM, MAY BE SHIPPED SEPARATELY. 1308571 5491909-01 MARK 13 Backordered: Item will follow SK —School Kit Discontinued: Item no longer available NC No Charge SHIP TO INVOICE DATE OF BOXES Special Schein Free Goods M Manufacturer will ship Item directl to y ou 1817102 11/13/08 11 p- Itescription Drug: Return Authorizuttion Required 11 Refrigerated Item: May be shipped separately cing U Temporarily unavailable: please reorder 1145220- 3 2 0 3 57�6 �4 1 OF 3 T Taxable Item Continued on Next Page WHSE DEA# Fed ID: 11- 3136-59i C This order aas been processed by our NORTHEAS D.C. 41 WEAVEZ ROAD DENVER, DA 175L7 ARK 1 677 -9945 EA CYLINDER WRENCH METAL SZ SM 6 6 1.95 11.70 1 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. F YOU ARE DARTICIPATING 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 SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULE'S. UDOT DISCOUNT RECEIPT OR REDEMPTION, OU ARE, RECEI ING OR WT_LL. R.CETVF OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT kGAINSq THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU 11AVE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS URCHA E, THEN ANY B NEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCES OF T OSE BENEFITS TIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDI E TOTAL 11.70 INVOI E TOTAL 11.70 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 11.70 BILL TO INVQI E" CUSTOMER POf ITEM STATUS KEY REM KEY 1308571 2074278-01 MARK B Backordered: Item will follow SK School Kit SHIP TO INVOICE DATE 4 OF BOXE D Discontinued: Item no longer acailablc NC No Charge P- Special Schein FrceGood, M Manulaaurer will ship Item dirccth u, you 1308572 11/06/08 1 P- Prescription Drug: Retain Authorization Required R ReGigerated Item: Mav be shipped sepaiateh HSI NUMBER INVOICE TOTAL PA E Special Schein Pricing U Temporank unavailable: please reorder 1145220— 1 11.70 1 OF 2 T Taxablehem Continued on Next Paae.......... H ENRY CHEW m SHIP TO: M cgtrx Carmel Fire Department MI I�I M Y® I C 540 W n 4 St Station 46 Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 0100001 30857105491909110010000002035641113089 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 2035.64 INvOICE# INVOICE DATE 5491909 -01 11/13/08 CUSTOMER Poll SHIP TO MARK I 1817102 J WHSE DEA# Fed ID: 11- 3136595 f 0 y n s s ,�,rac t. i..... a �w., N o w 7 107 -0540 90 /BX PURPLE NITRILE PIT GLOVE X -LARGE 10 10 C 8.50 85.00 10 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIOIN CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 8 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 50 50 4.83 241.50 3 9 602 -8100 EA COLLAR EXTRIC. STIFFNECK ADJ. 100 100 C 5.95 595.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 10 985 -5567 EA TUBE CHECK B 25 25 2.44 61.00 3 11 220 -2270 EA THOMAS HOLDER F /ET TUBE ADULT 25 25 3.05 76.25 3 12 499 -0708 U EA THOMAS ET HOLDER PEDI 15 15 3.05 45.75 3 13 499 -2182 EA LARYN HANDLE MEDIUM 5 5 12.00 60.00 3 14 857 -5266 EA DISP MIL LARYGOSCOP BLADE SZ 2 2 2 4.50 9.00 11 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 15 652 -5403 20 /BX STYLET INTUBATING 14FR 1 1 50.00 50.00 11 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTRELBUTION CENTER. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR 0 HER PECIAL AWA S "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF T E DISCO UNT.VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, I ND UPON ANY S CH BILL TO INVO ICE# CUSTO PO# ITEM STATUS KEY REM KEY 1308571 S491909-01 MARK 13 Backordered: Item will follow SK School Kit SHI TO INVOICE DATE OF BOXES D Discontinued: Item no longer available NC -No Charge F Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 11/13/08 11 P Description Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H ER Special Schein Pricing 114 5 2 2 0- 3 2 0 3 5. 6 4 2 OF 3 T- Taxable�lmunavailable: please reorder 14S220- Continued on Next a HENRY CHE N SHIP TO: Ugdrx Med i cal Carmel Fire Department MI 540 W 136 St INVOIC Station 46 Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel IN 46032 -8806 010000130857105491909110010000002035641 ,113089 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 2035.64 INVOICE# INVOICE DATE 5491909 -01 11/13/08 CUSTOMER PO# SHIP TO (MARK I 1817102 Please detach here and mail the above with your payment WHSE DEA# Fed ID: 11- 3136595 I ERR III; I W T rs sF Bonn, V _a. EQUEST, SUCH VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. IF YOU VE SED A HENRI SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY B NEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD Ill EXCES3 OF THOSE BENEFITS TIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. N HENRY 3CHEIN, INC. HAS PURCHASED THE SPE IFIC UNIT OF THE PRESCRIPTION DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 2035.64 INVOI E TOTAL 2035.64 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 2035.64 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102 1 ALATINE, I 60055 -0241 LL TO I CUSTOMER P ITEM STATUS KEY REM KEY 1308571 5491909-01 MARK It Backordered: Item will follow SK School Kit INVOICE DATE F B XE D Discontinued: Item no longer available NC No Charge SHIP TO P- Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 11/13/08 11 P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER Special Schein Pricing 114S220- 3 2 0 3 5. 6 4 3 O F 3 T- Ta xable unavailabte: please murder HENRY SCHE N TERMS OF l S A L f Pa rr 1 Terms: We make ever; effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN PLA TINUM BUSINESS catalog, however, we reserve the right to make .rice adjustments in CARD, VISA, MASTERCARD. DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes 'Zx visa Guaranteed Satisfaction:... or If you have tried a product and it is detective or does not perform Bill Your :j� er o n: Account our Ope satisfactorily, wee will provide a credit, refund, or exchange; its your Available to licensed practitioners in the U.S. All invoices are choice, SirnDly call Our customer service department within 30 days with 3 "u day's. of receipt of the merchandise to arrange for the return. For a pay able 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.rofessionals. If you are a new customer or have recently moved, please f um sh us tivith a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate verifying your shipping address. Class it drugs can be ordered only b, mail. international Orders: P lease D ote: We proudly serve healthcare p~otessionals and governments Opened handpieces and equipment may not be returned for throughout the world. To place orders or for inquiries on export cred rr it, but .�!ill be repaired or replaced in accordance Yvith terms and conditions, please contact our international Department: e Before opening handoieces or n. ra°tu�actr;r.,r %Yana, �t..e s. 'oUipment, we suggest that you check the shippin container and paging list tc 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 -8 845 -3550. LP300 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)) 5491909 -02 EMS Supplies $64.56 5491909 -03 EMS Supplies $69.94 2074278 -01 EMS Supplies $11.70 5491909 -01 EMS Supplies $2,035.64 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 VOUCHER NO. WARRANT NO, Henry Schein ALLOWED 20 IN SUM OF Dept Ch 10241 Palatine, IL 60055 $2,181.84 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 5491909 -02 .102- 390.11 $64.56 I hereby certify that the attached invoice(s), or 1120 5491909 -03 102- 390.11 $69.94 bills) is (are) true and correct and that the 1120 2074278 -01 102- 390.11 $11.70 1120 5491909 -01 102 390.11 $2,035.64 materials or services itemized thereon for which charge is made were ordered and received except NOV 2 4 2008 Title Cost distribution ledger classification if claim paid motor vehicle highway fund