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Home My WebLink About157090 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 `f. ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,372.40 CARMEL, INDIANA 46032 DEPT CH 10241 L4inh �o.. PALATINE IL 60055 -0241 CHECK NUMBER: 157090 CHECK DATE: 315/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION A02 4239011 5726876 -01 1,372.40 SPECIAL DEPT SUPPLIES �i. WHSE DEA# Fed ID: 11- 3136595 pa MP W t 10 499 -0386 PU EA FS NEBULIZER W/T MOUTHPC &02 RES 150 150 C 0.75 112.50 8 ASE GOOD ITEM, 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 PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, 'IOU ARE RECEI ING OR WILL RECEIVE 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, D UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSI THE PURCHASEI THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU HAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS URCHA E, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF THOSE BENEFITS IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS k DISCO T Al SIMILARLY DI CLOSED. MERCHANDI E TOTAL 1372.40 INVOI E TOTAL 1372.40 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1372.40 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI4 INC. EPT CH. 102 1 ALATINE, I 60055 -0241 BILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 5726876-01 MARK H Hackordercd: Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge S HIP TO INVOICE DATE 4 OF BOXES I' Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/19/08 10 P- Prescription Drug: Return Authorimtion Required R Refrigerated Item: May be shipped separately H I NUMBER INVOICE TOTAL PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220— 1 1372.40 2 OF 2 T Taxable hem Paym-ant Terms: We make ever, 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 {guaranteed Satisfaction: or It you have tried a product and it is detective or does not perform rer ou Op tr SatlStaCtO choice. Sir illy, Vr'@ Pill; pr0`llde a wreult, refund, Or eXChange; it "5 y 1r I� t o y are o in ,�ply call our customer service department 4Yith n 30 days Availab o lice °use:. practition s in the U.S. All in oices are f payaNle within 30 days, of receipt of the merchandise to arrange for the return. For a warranty repair or it you were sent something you did not order simply call: Rx Products Controlled Substances: Matra Medical 1- 800 845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered, licensed healthcare professionals. It you are a new customer or have recently moved, please tarnish us with a copy of your updated state registration. For controlled su ^stances, furnish a copy of your Dlz certificate, verifying your shipping address. Crass II drugs can be orderer: only by mail. International Orders: Please Nate: We proudly serve healthcare professionals and governments Opened handpieces and equipment may not be returned far throughout the Y;orld. To place orders or for inquiries on export credit, but w be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties, Before opening handpieces or 1- 800 345 -3:50 equipment, .ve 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 all Prescription Drugs. Simply cast our Customer Service Department -8 003 845 3550. LP300 WHSE,I)EA# Fed ID: H- 3136595 ININ I IF W -C jg MT. N =1 his order as been processed by our NORTHEAS" D.C. 41 WEAVER ROAD DENVER, )A 1751_7 1 985-9937 EA TUBECHECK A SYRINGE STYLE 20 20 2.35 47.00 10 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES" DISTRIBUTIO CENTER. 2 602-8100 EA COLLAR EXTRIC. STIFFNECK ADJ. 100 100 C 5.90 590.00 2 CASE..GOOD irEm, MAY BE SHIPPED SEPARATELY. 3 107-0501 100/BX PURPLE NITRILE PF GLOVE SMALL 10 10 C 8.25 82.50 3 7-ASE GOOD ICEM, MAY BE SHIPPED SEPARATELY. 4 107-0502 100/FX PURPLE NITRILE PF GLOVE MEDIUM 10 10 C 8.25 62.50 4 CASE GOOD ICEM, MAY BE SHIPPED SEPARATELY. 5 878-8721 EA ALCARE PLUS FOAM ALCOH OD 90Z 24 24 C 7.35 176.40 5 CASE GOOD IFEM, MAY BE SHIPPED SEPARATELY. 6 987-8856 200/BX GENIE LANCET SAFETY 1.50MM 3 3 58.00 174.00 9 7 499-0469 PU EA INFUSER DISPOSABLE 1000CC 6 6 12.50 75.00 9 8 100-0592 6/PK PENLIGHT DISPOSABLE 4 4 4.75 19.00 9 9 890-1375 50/PK VERSALON NON-WOVEN SPONGE 2"X2" 10 10 1.35 13.50 9 BILL TO INVOICE14 CUSTOMER PQ# ITEM STATUS KEY REM KEY 1308,571 5726876-01 MARK 13 Backordered: Item will follow SK School Kit Discontinued: Item no lon available NC -No Char SHIP TO INVOICE DATE OF BOXES i- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/19/08 10 11 Prescription Dru Return Authorisation Required R Refrigerated Item: May be shipped separately HSI NUMBER TNVOICE TOTAL PAGE4 Special Schein pricing U Temporarily unavailable: please reorder 1145220- 1 1372.40 1 OF 2 T- Taxable Item Continued on Next Page 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)) 02/19/08 5726876 -01 EMS Supplies $1,372.40 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 N ALLOWED 20 pry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,372.40 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept.# INVOICE N0. ACCT #/TITLE AMOUNT Board Members 5726876 -01 102 390.11 $1,372.40 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