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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