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Home My WebLink About165262 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,880.82 PALATINE IL 60055 -0241 CHECK NUMBER: 165262 CHECK DATE: 10/29/2008 DEPARTMENT ACCOUNT P NUMBER IN NUMBE AMOUNT DESCRIPTION '1-102 4239011 5141901 -01 1,836.32 SPECIAL DEPT SUPPLIES. 102 4239011 5142200 -01 44.50 SPECIAL DEPT SUPPLIES e v ed 4 x WHSE DEA# Fed ID: 11- 3136595 IN This order has been processed by our NORTHEAST D.C. 41 WEAVER ROAD DENVER, DA 1751-7 1 4ARK 317-423-8784 17 -571 -266 1 555 -5396 PU EA PROTECTIV ACUVNC SFT CATH 20X1.25 200 200 C 2.64 528.00 11 HIS PRODUCU IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTION CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 8913037 U 50 /CA IV PREP KIT W/ TEGADERM 4 4 C 59.83 239.32 4 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 20 20 C 8.25 165.00 6 ASE GOOD Z EM, MAY BE SHIPPED SEPARATELY. 4 120 -9201 EA BANDAGE TRIANGULAR N/S 40X56" 240 240 C 0.30 72.00 7 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 5 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 80 80 4.65 372.00 10 6 338 -2276 U 100 /CA EXTENSION SET STD BORE UL 2 2 C 230.00 460.00 9 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE DARTICIPATING 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 S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM FILL TO IUVOICE# CUST MER Pelf ITEM STATUS KEY REM KEY 1308571 5141901-01 MARK HUI ETT B Backordered: Item will follow SK School Kit HIP T INVOICE DATE F BOXES D Discontinued: Item no longer available NC No Charge I' Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 10/15/08 11 P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NINBER INVOICE TOTAL PA E Special Schein Pricing U Temporarily unavailable: please reorder 145220- 3 1836.32 1 OF 2 T Taxable Item Continued on Next Page HENRY CHEIN SHIP TO: Matrx Medical Carmel Fire Department MI INVOIC Station Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 010000130857105141901110010000001836321015084 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 1836.32 INVOICE# INVOICE DATE 5141901 -01 10/15/08 CUSTOMER PO# SHIP TO MARK HUIETT 1817102 Please detach here and mail the above with your payment WHSE DEA# Fed ID: 11- 3136595 „3 t L ;a. a n r RULES. UPOR DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE OTICE OF THE 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 R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE U SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS DURCHASE, THEN ANY B NEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS TIVIEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 1836.32 INVOI E TOTAL 1836.32 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 1836.32 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEI4 INC. DEPT CH 10211 ALATINE, I 60055 -0241 LL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 5141901-01 MARK HUI ETT 13 Backordered: Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge HI T INVOICE DATE F B XE F Special Schein Free Goods M Manulactmer will ship Item directly to you 1817102 10/15/08 11 P Prescription Drug: Return Authorization Required R Refrigerated Item: n1ay be shipped separately H I NUMBER INVOICE TOTAL PAGE Special Schein Pricing 1145220— 3 1836.32 2 OF 2 T- Taxable I available; please reorder L 1; HENRY SCHEIN Matrx Medical ERMS OF r= S' I-- ayrnf :o4 Terms: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN PLATINUM BUSINESS catalog, however. we reserve the right to make price adjustments in CARD, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers price changes Y 6uslro Wme 1 Q --a Guaranteed Satisfaction: If you have tried a product and it is defective or does not perform o r Your Or To c >ur Open Account satisfactorily, we will provide a credit, refund, or exchange; it's your choice. Simply call our customer service depa tment within 30 days Avai a^ e o licensed practitioners is the U.S. X111 invoices are of receipt of the merchandise to arrange for the return. Fora payable within 30 days. warranty repair or if you were sent some t! ing you did not order simply calf: x Products Controlled Substances: atrx Me 1- 800 845-3550 Regulations require us to limit the sate of Rx and controlled substances only to registered, licensed healthcare professionals. It you are a new customer or have recently moved, please fumish us with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA cerificate, verifying your shipping address. Class 11 drags can be ordered only by mail. International Orders: Pleas Nate: Open hand pieces and may not be returned for We roudl serve healthcare professionals and governments p p equipment u throughout the world. To place orders or for inquiries on export credit but will be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties. Before opening handpieces or 1- 800 -845 -3550 equipment, we suggest that you check the shipping container 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 ail Prescription Drugs. Simply call our Customer Service De,parrnent 1- 800 -845 -3550. WHSE DEA# Fed ID: 11-3136595 his order as been processed by our NORTHEAS" D.C. 41 WEAVER ROAD DENVER, )A 1751.7 qARK HUIETT 317-428-8784 1 104-2125 EA CALIPER EKG 40MM METRIC SCALE 10 10 4.45 44.50 1 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER PECIAL AWARDS ("DISCOUNT")), WITH THIS PURCHASE YOU HAVE EARNED A CREDIr' TOWARD GOODS OR S3RVICES, RECEIVABLE OR REDEEMABLE N ACCOZDANCE WITH DISCOUNT PROGRAM RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RICEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI('ARE OR )THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY STCH EQUEST, SU VALUE MUST BE DISCLOSED AS A DI COUNT GAINS `I THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. IF YOU IAVE JSED A HENRC SCHEIN ("HS") CREDIT CARD TO MAKE THIS DURCHASE, THEN ANY BINEFITS 'ROM PURCHA3ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF TI-.OSE BENEFITS GIVEN OR NON-HS )URCHASES MUST ALSO BE TREATED AS A DISCO AN E SIMILARLY DISCLOSED. IF: ATTN RK HUIETT MERCHANDI'E TOTAL 44.50 INVOITE TOTAL 44.50 PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS INVOICE. 44.50 BILL TO INVOICE T MER PO# ITEM STATUS KEY REM KEY It 1308571 5142200-01 MARK Backordrrcd: Item e ill lollow School a Ki 1 Discontinued: Item no longer available M _j SHIP TO TNVOICE DATE 11 QF RES Special Schein free Goods M Manufacturer will ship Item directly to you 13085 72 10/15/08 1 1) prescription Drug: Return Authorization Required R Refrigerated Item: May he shipped separately HSI NUMBER INVOICE TOTAL PIAGE4 Special Schein Pricing U Temporarily unavailable: please reorder L6 1145220- 1 44.50 OF 2 J T Taxable Item Continued on Next Page Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) c 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)) 5142200 -01 EMS Supplies $44.50 5141901 -01 EMS Supplies .$1,836.32 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. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,880.82 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 5142200 -01 102- 390.11 $44.50 1 hereby certify that the attached invoice(s), or 1120 5141901 -01 102 390.11 $1,836.32 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 OCT 2 7 2008 Title Cost distribution ledger classification if claim paid motor vehicle highway fund