HomeMy WebLinkAbout161859 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,507.77
PALATINE IL 60055 -0241 CHECK NUMBER: 161859
CHECK DATE: 7123/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 1062505 -01 1,507.77 SPECIAL DEPT SUPPLIES
WHSE DEA# Fed ID: 1 1- 3136595
0 f
e� tea" rs
his order ias been processed by our NORTHEAS D.C.
41 WEAVEZ ROAD
DENVER, A 1751_7
VIARK 317-57L-2663
ELL 317 -57 -8784
1 891 -3037 PU 50 /CA IV PREP KIT W/ TEGADERM 4 4 C 59.88 239.52 4
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
2 120 -8808 EA COMBITUBE ROLL -UP KIT 41FR 5 5 42.75 213.75 8
3 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 30 30 C 8.25 247.50 7
ASE GOOD 117EM, MAY BE SHIPPED SEPARATELY.
4 555 -8102 PU EA PROTECTIV ACUVNC SFT CATH 16X1.25 50 50 2.69 134.50 9
HIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER.
5 555 -6439 PU EA PROTECTIV ACUVNC SFT CATH 14GX2" 50 50 2.69 134.50 9
HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER.
6 555 -1166 PU EA PROTECTIV ACUVNC SFT CATH 18X1.25 100 100 2.69 269.00 9
HIS PRODUCP IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER.
7 555 -5396 PU EA PROTECTIV ACUVNC SFT CATH 20X1.25 100 100 2.69 269.00 9
HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER.
BILL TO INVOICE INVOIC CUS TOMER PO ITEM STATUS KEY REM KEY
1308571 1062505-01 MARK HUE I TT 13 Backordered: hem will follow SK School Kit
U Discontinued: Item no loneer available NC -No Charee
HIP TO INV I E DATE OF BOXES F Special Schein Free Goods
M Manufacturer will ship Item directly to y ou
1308572 7/08/08 9 P- Prescription Drug: Return Authorization Required
R- Relrigerated Item: May be shipped separately
H I NUMBER INVOICE TOTAL PAGE# Speeial Schein Pricing
U Temporarily unavailable: please reorder
1145220— 1 1507.77 1 OF 2 T TaxableItem Continued on Next Page..........
HENRY SCHEIN
SHIP TO:
M atrx Med Carmel Fire Dept Head Quarters MI
2 Civic
IN VOIC E Carmel,IN
46032 -2584
135 Duryea Road, Melville, NY 11747
010000130857101062505110010000001507770708089 BILL TO:
Carmel Fire Dept MI
2 Civic Sq
Carmel, IN 46032 -7543
Carmel Fire Dept MI
2 C1V1C SC; BILL TO INV TOTAL
Carmel, IN 46032 -7543
1308571 1507.77
INVOICE# INVOICE DATE
1062505 -01 7/08/08
CUSTOMER PO# SHIP TO
MARK HUEITT 1308572
Please ktach hem and mail the above with your payment
WHSE DEA# Fed ID: 11-3136595
m ,a Td
r- l
fA A 6 F C 0 its
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 EARNED A CREDI TOWARD
GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM
RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL R=IVE
OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRI ARE OR
THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, IND UPON ANY S CH
EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSU THE PURCHASE THAT
ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU ILAVE
SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS
F ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF THOSE BENEFITS TIVEN
OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED.
/F: MARK H EITT
MERCHANDI E TOTAL 1507.77
INVOI E TOTAL 1507.77
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1507.77
LEASE NOTE NEW REMIT TO ADDRESS
P lease remi payments only to the following a dress:
H ENRY SCHEI4 INC.
D EPT CH 10211
ALATINE, I 60055 -0241
13 ILL TO INVOTCE4 CUSTOMER P0# ITEM STATUS KEY REM KEY
1308571 1062505-01 MARK HUEITT 13 llackordered: Item will follow SK school Kit
U Discontinued: Item no longer available NC No Charge
HIP INVOICE DATE F BOXES 1= Special Schein Free Goode
M Manufacturer will ship Item directly to y ou
1308572 7/08/08 9 P- Prescription Drug: Return Authorization Required
R Refrigerated Item: May be shipped separately
I NUMBER INVOICE TOTAL PAQE# special Schein Pricine
1145220— 1 1507.77 2 O F 2 T- Ta able I�cm unavailable: plea reorder
s
_1__1.11 11.11..___
HENRY SCHEIN
m atrx medical ..1111_ W WW:- W _W_ 1 111._ T E IR M S 1111
Payment 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 BWlno [cww
fC1 h3 #4 V 1N fl"
Guaranteed Satisfaction:
or
It you have tried a product and it is defective or sloes not perform Bill Your Order To Your Open A ccount
satisfactorily, vve will provide a credit, refund, or exchange: it's your Available to licensed practitioners in the U.S. All invoices are
choice. Simpi y call our customer service department within 30 days
of receipt of the merchandise to arrange for the return. For a f payaule 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 Rx and controlled
substances only to registered, licensed healthcare professionals.
if you are a new customer or have recently mov ;d, please furnish
us vdth a copy of your updated state registration. For controlled
substances, furnish a copyy of your DEA certificate verifying your
shipping address. Class ll drugs can be ordered only by mail.
International Orders:
Please Note:
'e proraly SetUE healthcare p rofessionals and governments
handpieces and equipment may not be returned for 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 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 Re for all Prescription Drugs. Simply call
our Customer Service Geparment' -800-845-355
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))
07/08/08 1062505 -01 EMS Supplies $1,507.77
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
$1,507.77
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 1062505 -01 102 390.11 $1,507.77 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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund