The URL can be used to link to this page

Home My WebLink About163233 09/03/2008 *F CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $3,231.27 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 163233 CHECK DATE: 9/3/2008 DEPARTME ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 7562643 -01 3,231.27 SPECIAL DEPT SUPPLIES f'c i WHSE DEA# Fed ID: 11- 313695 a his order as been processed by our NORTHEAS D.C. 41 WEAVEK ROAD DENVER, A 175L7 ARK 317-423-8784 17 -571 -266 1 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 30 30 C T 8.36 250.80 3 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 40 40 C T 8.36 334.40 7 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. I 3 107 -0540 90 /BX PURPLE NITRILE PF GLOVE X -LARGE 30 30 C T 8.36 250.80 10 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 4 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 100 100 T 4.95 495.00 21 5 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 60 60 C T 4.64 290.40 13 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 6 602 -8100 EA COLLAR EXTRIC. STIFFNECK ADJ. 100 100 C T 5.95 595.00 15 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 7 878 -8721 EA ALCARE PLUS FOAM ALCOH OD 90Z 12 12 T 7.40 88.80 22 8 891 -3037 LASEGOOD IV PREP KIT W/ TEGADERM 3 3 C T 59.88 179.64 18 I EM, MAY BE SHIPPED SEPARATELY. BILL TO INVOIC CUSTOMER PO# I ITEM STATUS KEY REM KEY 1308571 7562643 -01 MARK HUIETT 1t- Backordered: Item witlfouow SK SchoolKit HIP TO INVOICE DATE OF BORE D Discontinued: Item no longer ncailable NC No Charee P Special Schein Free Goods M Manufactwei will ship Item direxnle to you 1817102 8/14/08 2 3 P Prescription Drug: Return Authorization Required IZ Refrigerated Item: May be shipped separateh HSI NWBER INVOICE S Special Schein Pricing 1145220— 3 3444.66 1 OF 3 T- Taxable lm n unacailable: ple,i e reorder Continued on Next Page H ENRY SCI IEIN SHIP TO: Matrx Medical Carmel Fire Department MI INVOIC 540 W 136 St Station 46 Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 01000011308571075626431 ,1001,0000003444660814088 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq Carmel IN 46032 -7543 BILL To INVOICE TOTAL 1308571 3444.66 INVOICE# INVOICE DATE 7562643 -01 8/14/08 CUSTOMER PO# SHIP TO MARK HUIETT 1817102 WHSE DEA# Fed ID: 1 1- 3136595 a sj_� s.,. w,l�. .z� n.. .»wFB 7s�<x.s_� xs�rt_�� 'g z'+z' �s-as��- �C�n R 9 507 -8362 PX 100 /BX NACL PREFILL SYRINGE 3 3 61.00 183.00 19 1 4 2 PEDIGREE ITEM. DC:0638070 010 10 555 -5396 PU EA PROTECTIV ACUVNC SFT OATH 20X1.25 150 150 T 2.40 360.00 23 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO2 CENTER. 11 987 -1566 PU 100 /BX SYR.W /NEEDLE 5CC 20X11/2 LUERLCK 2 2 T 16.50 33.00 21 12 987 -4051 PU 100 /BX SYR.W /NEEDLE 1OCC 20X11/2 LUERLCK 2 2 T 18.34 36.68 19 13 326 -2005 EA OBSTETRICAL KIT /POUCH 25 25 T 5.35 133.75 20 F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POT_N S GIFTS OR n HER PECIAL AWA DS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOi DISCOUNT RECEIPT OR REDEMPTION, MU ARE RECEI ING OR WILL RECEIVE s OTIC-E -OF -T E- DISCOUNT VALUE.- FROM TI ME TO TI, E, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY S17CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSI THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU VE SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS DURCHASE, THEN ANY BENEFITS ROM PURCHASES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS TIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. 2 HENRY 3CHEIN,INC. DISTRIBUTES THIS DRUG PRODUCP AS AUTHORIZED ISTRIBUTOR OF RECORD FOR THE MANUFACTURER. BILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 7562643-01 MARK HUI ETT It Backordered: Item will Cello, SK School Kit D Discontinued: Item no loneer available NC No Charee HIP TO INVOICE DATE OF B XES P Special Schein Pttie Goods M Manufacimer will ship Item directly to you 1817102 8/14/08 2 3 P Prescription Drug: Retain Authorization Required R Rehi Item: May be shipped separately H' NUMBER I E J P E S- Special Schein lIncine u Temporarih unavailible: please reorder 1145220- 3 3444.66 2 OF 3 T Taxable Item Continued on Next Page ENRY CHEIN SHIP TO: Matrx Medical Carmel Fire Department MI INVOIC 540 W 136 St Station 46 Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel IN 46032 -8806 0100001308571075626431110010000003444660814088 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq r BILL TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 3444.66 INVOICE# INVOICE DATE 7562643 -01 8/14/08 CUSTOMER PO# SHIP TO MARK HUIETT 1817102 Please detach here and mail the above with vour payment WHSE DEA# Fed ID: 11- 3136595 i :"•r ti' W S 1 a r. �r�ri is r r a n o av e' sa to i; a�n^ Y! MERCHANDISE TOTAL 3231.27 S LES TAX INVOI E TOTAL 66 PLEASE PAY WITHIN THIRTY(3 DAYS OF RE EIPT OF THIS NVOICE. 66 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: H ENRY SCHEIq INC. D EPT CH 10211 ALATINE, I 60055 -0241 BILL TO INVOICE# CUSTOMER INVOICE P ITEM STATUS KEY REM KEY 1308571 7S62643-01 MARK HUI ETT I3 Ilackordered: Item will follow St; School Kit HIP TO INVOICE DATE OF B XE Discontinued: Item no lonecr available NC NoChwec 1 Special Schein t Goods N1 Manufacturer will ship Item directly to you 181710 2 8/14/08 2 3 Prescription Dive: Return Authorization Required R Refriewrated Item: May be shipped separately HSI NUMBER JNVOJCE TOTAT, PAGE Special Schein Pricing 114 5 2 2 0— 3 3444.66 3 OF 3 T- T axable u navailable; please reorder le Ite i I Matrx I a F &a E r vkn make every effc to maintain. prices for the J: lration ,t a Payment by CHECK car y the HENRY SC EIN PLATINUM BUSINESS a cataiog, however. we reserve the righ to make :;rice adjus nents in CARD, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS res:orrse f4 rnanufacture°s' pr iu changes Y 9WIrosaN I I VISA Guaranteed Satisfaction: It ,+ou na;; tried a Inroduni and i, is d efective or do not perform �C s �i F I ESfa o €It �'1';I p 1' S� "s vi�'<3e orevl r und, Or eXCnPtlyc fie ^ur Available t o licensed pract itioners in the U.S, All invoices are j Choic Sim k v cal: our custcmanr sere €v4: d'e,Ciartment w'; i:n 310 days k iCeil t of t he rnBrUt a 8 f or U artaul ,''it lip G o* nd s to arran e f r retum; For a warran repair or if you were sent sorne.`fing VCu d not order sm0 call: Rx Products Controlled Substances: I trx Medical 500 -845 -3550 egulat=ons require us to iimi the saii of Px an 's ntrol e^ substances oily to registered, iiceriseui i eaithca. crofessicnais. f you are a new custorner or have recently rnaved P lease t ;.rmsh us `s` /it'i a cony of your updated state reds`rafion. For con rolled su lsta;'lces, f �rnESrl a Co >y of `Our" S ea-, verifyEri'o ',s'our shipping au Tress. Class l drags can be oil, u cnl,, y ;jail. International Orders: P_ le Noted ma s and Opened haidpilced equioment no li ,.':1' "9 r r 5 e €i a €.:a€k a un�i ;z€ ;i1114E':s n r u ,hr„ rlg "'o the ;:o u. J �,Eace orders o cre n €o E uE .es on exwort ..nil be repaired o replaced n accordance w ith t t r z =.r:. mils an )rraEtl)r:v, EJE :asa con'.act ilr t ntaloi ?el t ann €urlt: rnanufaca"'mr t. ^rraf':._ess, Before opening handl):He Mr >.,i li. r'C suage.i ,r't you c 1heck the shipping con.taine. 11 t 'tn ,DUia tic exact .:Ct 'rescr s D ruc j s" turns in t uciio t �.,,r „a. rser computer S urtware is not returnable. Other restrictions may also apply. A Return Authcri7.,tion is Reouired fo, a'1 Prescr.intic n Drugs, SinicIv ca l our Cust )rner Se-Vice epa[a...',nt td I-800 e 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)) 7562643 -01 EMS Supplies $3,231.27 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. WAR NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $3,231. ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 7562643 -01 102 390.11 $3,231.27 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 AUG 2 9 7 008 -1/ n f t �q 1 Title Cost distribution ledger classification if claim paid motor vehicle highway fund