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Home My WebLink About156613 02/21/2008 f CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $2,223.26 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 156613 CHECK DATE: 2/2112008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTIO 102 4239011 219660 -01 35.70 SPECIAL DEPT SUPPLIES 102 4239011 219731 -01 35.00 SPECIAL DEPT SUPPLIES 102 4239011 229270 -01 1,110.66 SPECIAL DEPT SUPPLIES 102 4239011 2839344 299.40 SPECIAL DEPT SUPPLIES 102 4239011 6840230 742.50 SPECIAL DEPT SUPPLIES WHSE DEA# Fed ID: 11-3136595 ram d� `�,da'x, ./u,�� M ,r ta�� a e''d. �€_�P r; d��, .:aaL��T�q c b. x c, T his order has been processed by our NORTHEAS D.C. 41 WEAVEIZ ROAD DENVER, DA 175 17 17 -571 -266 17- 428 -878 r ARK 1 360 -8615 EA PROSCOPE PEDIATRIC 675 R BLUE 6 6 5.95 35.70 1 F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA S "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR .S RVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEIPT OR RELEMIPTION, OU ARE RECEI'ING Oi WILL rt CEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR O THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSrl THE PURCHASET THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS DURCHA E, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES OF T OSE BENEFITS TIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. OUR ORDER 55916277 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEMT WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE [TEMS WHEN THEY ARE IHIPPED MERCHANDI E TOTAL 35.70 INVOI E TOTAL 35.70 PLEASE PAY WITHIN THIRTY(3 DAYS OF RE EIPT OF THIS NVOICE. 35.70 BILL To INVOICE# CUSTOMER Po ITEM STATUS KEY REM KEY 13 219660 MARK 13 Backordered: I[em will follow SK School Kit D Discontinued: Item no longer available NC -No Charge SHIP TO INVOICE DATE If OF BOXES P Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/29/08 1 P- Prescription Drue: Return Authorization Required R Retnuerated Item: May be shipped separately HSI NUMBER INVOICE TOTAL PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 35.70 1 OF 2 T Taxable Item Continued onNext Page WHSE DEA# Fed ID: 11- 3136595 17 -571 -266 17- 428 -878 RK 1 499-1966 EA STRAPS REPL ADULT FW444 1 1 35.00 35.00 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR O HER PECIAL AWARDS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO a DISCOUNT RECEIPT OR REDEMPTION, yoU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND UPON ANY STICH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSq THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY; YOU SHOULD RE AIN THESE RECORDS. IF YOU IIAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAKE, THIS URCHA E, THEN ANY BENEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF T OSE BENEFITS GIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. OUR ORDER 55916277 HAS BEEN SPLIT INTO MULTIPLE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE TEMS IAHEN THEY ARE HIPPED MERCHANDI E TOTAL 35.00 INVOI E TOTAL 35.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 35.00 BILL TO INVOICEit CUSTOMER PQ# ITEM STATUS KEY REM KEY 1308571 219731-01 MARK 13 Backordered; Item will follow SK School Kit HIP TO INVOICE ATE OF BOXES D Discontinued: Item no longer available NC No Charge P- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/05/08 P Prescription Drug: Return Authorization Required H Z NINBER INVOICE TOTAL PAGE R Refrigerated Item: May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder 114S220- 1 35.00 1 OF 2 T- Taxable Item Continued on Next Page LP300 WHSE DEA# Fed ID: 11- 3136595 nzvy his order as been processed by our NORTHEAS D.C. 41 WEAVE: ROAD DENVER, A 175 7 1 891-3037 PU 50/CA IV PREP KIT W/ TEGADERM 5 5 C 59.88 299.40 5 HIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES'" DISTRIBUTIO1 CENTER. CASE GOOD IrEM, MAY BE SHIPPED SEPARATELY. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G., POINqS, GIFTS OR O'HER PECIAL AWAZDS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCOZDANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R;CEIVE IOTICE OF THE DISCOUNT VALUE- -FROM -TIME TO TIME, MEDICARE, MEDICAID, TRI('ARE OR DTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VkLUE, PND UPON ANY STCH REQUEST, SU VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINS 7 THE PURCHASE!; THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE' THESE RECORDS. IF YOU RAVE USED A HENRC SCHEIN "HS CREDIT CARD TO MAKE THIS DURCHASE, THEN ANY BENEFITS FROM PURCHA3ES OF HS PRODUCTS WITH THE CARD I EXCES3 OF THOSE BENEFITS TIVEN FOR NON-HS :1URCHASES MUST ALSO BE TREATED AS t DISCO AN E SIMILARLY DISCLOSED. MERCHANDISE TOTAL 299.40 INVOI E TOTAL 299.40 PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS NVOICE. 299.40 131 TO In OICEff CUSTOMER PO# ITEM STATUS KEY TTEM KEY -01 1308571 2839344 MARK 13 Backordered; Item will follow SK School Kit D Discontinued: Item no lon available NC No Charge SHIP TO INVOICE DATE OF BOX S F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/05/08 5 P- Itmription Drug: Return Authorization Re R Refrigerated Item: May be shipped separately H NUMBER INVOICE TO PAGE# Special Schein pricing U Temporarily unavailable: please reorder Continued on Next Page.......... 1145220- 1 29 9.40 1 OF 2 T Taxable Item WHSE DEA# Fed ID: 11- 3136595 t a 0C �f 0 t ik'f "3 D 9• 0 0 his order ias been processed by our NORTHEAST D.C. 41 WEAVEZ ROAD DENVER, DA 17517 1 4 ARK 317-57--2663 MA RK 317 -42 -8784 1 499 -0671 PU EA MASK INF MED CONC TUBING 7' 12 12 2.75 33.00 2 2 499 -0721 U EA ISOLATION KIT 24 24 4.95 118.80 2 3 507 -8362 100 /BX NACL PREFILL SYRINGE 2 2 69.23 138.46 2 2 PEDIGR E ITEM. DC:0638070 010 4 555 -5923 PU EA IV CATHETER JELCO 20X11/4 200 200 C 1.40 280.00 1 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. M FG BOXES O LY 5 857 -9052 EA DISP MAC LARYNGSCOP BLADE SZ 2 10 10 4.50 45.00 4 HIS PRODucr IS BEING SHIPPED FROM OUR MIDWES DISTREBUTIOIS CENTER. 6 857 -2059 EA DISP MAC LARYNGSCOP BLADE SZ 3 10 10 4.50 45.00 4 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 7 857 -1785 EA DISP MAC LARYNGSCOP BLADE SZ 4 10 10 4.50 45.00 4 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 8 857 -5362 EA DISP MIL LARYGGSCOP BLADE SZ 0 10 10 4.50 45.00 4 BILL INVOICE INVOICE4 CUSTOMER PO# ITEM STATUS KEY REM KEY 1 3 0 8 5 71 229270-01 MARK B Backordered: Item will follow SK School Kit S HIP T INVOI E ATE F BOXES D Discontinued: Item no longer available NC No Charge 1= Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/29/08 4 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I HER INVOICE TOTAL PA E Special Schein Pricing U Temporarily unavailable: please reorder 114S220- 1 1110.66 1 OF 3 T T-aMc Item Continued on Next Page L HENRY SCHEIN SHIP TO: Carmel Fire Dept Head Quarters MI INVOIC Carmel,INg46032 -2584 135 Duryea Road, Melville, NY 11747 01, 00001, 30857100229270110010000001110660129083 BILL To: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 HILL To INVOICE TOTAL 1308571 1110.66 INVOICE# INVOICE DATE 229270 -01 1/29/08 CUSTOMER PO# SHIP TO MARK 1308572 WHSE DEA# Fed ID: 11- 3136595 HIS PRODUCT IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIO11 CENTER. 9 857 -1425 EA DISP MIL LARYGOSCOP BLADE SZ 1 10 10 4.50 45.00 4 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTREBUTIO1 CENTER. 10 857 -5266 EA DISP MIL LARYGOSCOP BLADE SZ 2 10 10 4.50 45.00 4 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTREBUTION CENTER. 11 857 -3605 EA DISP MIL LARYGOSCOP BLADE SZ 3 10 10 4.50 45.00 4 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIOIN CENTER. 12 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 20 20 4.80 96.00 2 13 891 -5261 EA ACCU -CHEK ADVANTAGE CARE KIT 2 2 64.70 129.40 3 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, 'IOU 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 V LUE, jnND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. IF YOU WAVE SED A HENRC SCHEIN "HS") CREDIT CARD TO MAKE THIS DURCHASE, THEN.ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES OF T OSE BENEFITS GIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. 2 HENRY CHEIN,INC. DISTRIBUTES THIS DRUG PRODUCC AS AUTHORIZED ISTRIBUTOR OF RECORD FOR THE MANUFACTURER. BILL TO INVOICE# CUSTOMER PO4 ITEM STATUS KEY r RTE M KEY 1308571 229270-01 MARK B Backordered: Item will follow SK School Kit HIP T INVOICE DATE F BOXES D Discontinued: Item no longer available NC- No Charge 1- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/29/08 4 P- Prescription Drug: Return Authorization Required R- Refrigerated Item: May be shipped separately H I MIIER INVOICE T TAL PAGE Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 1110.66 2 OF 3 T Taxable Item Continued on Next Page.......... L HENRY SCHEIN SHIP TO: Matrx Medical Carmel Fire Dept Head Quarters MI INVOIC Carmel,IN -2584 135 Duryea Road, Melville, NY 11747 0100001130857100229270110010000001 ,110660129083 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 Civic .SCI BILL TO INVOICE TOTAL Carmel, IN 46032 -2584 1308571 1110.66 INVOICE# INVOICE DATE 229270 -01 1/29/08 CUSTOMER PO# SHIP TO MARK 1308572 please detach here and mail the above with your payment WHSE DEA# Fed ID: 11- 3136595 a mg—g MERCHANDI E TOTAL 1110.66 INVOI ('E TOTAL 1110.66 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1110.66 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102 1 ALATINE, I 60055 -0241 BILL T I e T ME P ITEM STATUS KEY REM KEY 1308571 229270-01 MARK B Backordered; Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge HIP TO INVOICE DATE OF 13OXES F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/29/08 4 p- prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER INVOICE TOTAL PAGE S Special Schein pricing 114 5 2 2 0- 1 1110 6 6 3 O F 3 T- Taxable Item unavailable: please reorder L 1 H ENRY CHEIN -7-1-1-1--= I Matrx Medicai TERMS OF S ALE Payrtient Ternis, We make every ettort 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: 's m It you have tried a product and it is defective or does not perform ill Y Or arr$un satisfactorily, we will provide a credit, refund, or exchange; it's your Available to licensed practitioners in the U.S. All invoices are choice. Simply call our customer service department within 30 days ray able within 30 day of receipt of the merchandise to arrange for the return, For a 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 moved, please tumish us with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate verifying your shipping address. Mass f dugs can be ordered only by mail, International Orders: Please N ote Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governments credit, but will be repaired or replaced in accordance with throughout the world. To place orders or for Inquiries on export manufacturer kvarranties. Before opening handpleces or terms and conditions, please contact our International Department: equipment, we suggest that you check the shipping container 1-800-845-3550 and pack.ng list to verify that you have received exactly ;,Tat Prescription Drug Returns Instructions: you ordered.Opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all `'rescript on Drugs. Simply call our Customer Service Department 1- 800 845 3550. 0 V- e `a SHIP TO: Matrx Carmel Fire Dept Head Quarters MI Med 2 Civic Sq INVOIC Carmel,IN 46032 -2584 135 Duryea Road, Melville, NY 11747 01, 0000130857102839344110010000000299400205084 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 C1VZC Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -2584 1308571 299.40 INVOICE# INVOICE DATE 2839344 -01 2/05/08 CUSTOMER PO# SHIP TO MARK I 1308572 Please detach here and mail theabove with your payment WHSE DEA# Fed ID: 11- 3136595 t a a� Emma x, t+t '3,..s ^�r i1:rl.m r?- o y LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following address: H ENRY SCHEIN INC. D EPT CH 10211 ALATINE, I 60055 -0241 BILL TO INV I E CUSTO O ITEM STATUS KEY :R M KEY 13 08571:. 2839344-0 MARK H Backordered: Item will follow ol K IP T NV F B X& D Discontinued: Item no longer available No Charge I' Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/05/08 5 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER Special Schein Pricing Tempora 1145220- 1 299.40 2 OF 2 T- Taxable I unavailable: please Border HENRY CHEII` matrx Medical TERMS OF SALE, Fl yroent 7e "is: VYe 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 YW WAf�N ma //ccAA Guaranteed Satisfaction: s or If you have tried a product and it is defective or does not perform rII ter wr °r Account satisfactorily, we wil! provide a credit, refund, or exchange; it s your Available to licensed practitioners in the U.S. All invoices are choice. Sim,DIV call our customer service department within 30 clays within 3 da 5 of receipt of the merchandise to arrange for the return. For a payable v 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 it the sale of Rx and controlled substances only to registered, licensed healthcare professionals. ;f you are a new customer or have recently moved, please furnish us swim a copy of your updated state reds ration. For controlled substances, furnish a copy of your DEA certificate verifying Your shipping address. Cass II drugs can be ordered only by mail. International Orders: Please Note: W proudly serve healthcare professionals and goivernments Opened handpiPces and equipment may not be returned for throughout the world. To piace 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 handpiecas or 1-800-845-3550' equipment, Svve suggest that you check the shipping container and paging list to yeti #y 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 Reauired for all Prescription Drugs. Simply call ol;r C ustornat, Se Mce Departmar -'�u3 -845 3515) x r._ —.fi �).x:; LP300 HENRY SCHEIN SHIP TO: M atrx Medical Carmel Fire Dept Head Quarters MI IN V OICE 2 Civic Carmel,IN -2584 135 Duryea Road, Melville, NY 11747 010000130857100219731110010000000035000205084 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 Civic Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -2584 1308571 35.00 INVOICE INVOICE DATE 219731 -01 2/05/08 CUSTOMER PO# SHIP TO MARK 1308572 Please detach ere and mail the above with your payment WHSE DEA# Fed ID: 11-3136595 P F 4 t tuG LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following address: ENRY SCHEI4 INC. EPT CH 10211 ALATINE, I 60055 -0241 BI TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 219731-01 MARK 13 Backordered: Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge S HIP T INVOICE DATE F BOXES F Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 2/05/08 P- Prescription Drug: Return Authorization Required H I NUMB INV I E TOTAL pp E R Refrigerated Item: May be shipped separately Special Schein Pricing 1145220- 1 35.00 2 O F 2 T- Taxable Te mpo r arily please reorder L Y SCHEIN 0 matrx medicai T ERMS OF SALE i __i Payment Tei ins: V'tie 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 Guaranteed Satisfaction: or If you have tried a product and it is defective or does not p erform if,r Omer" Your aunt satisfactorily, we will provide a credit, refund, or exchange, it's your Available to licensed practitioners in the U.S. All invoices are choice. Simply call our customer service department within 30 days payable within n days. of receipt of the merchandise to arrange for the return. For a 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 moved, please furnish us with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate, verifying your shipping address. Class 11 drugs can be ordered only by mail. International Orders: Pleas N ote: Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governnienls credit, but will be repaired or replaced in accordance with throughout the world. To place orders or for inquiries on export 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.ened Computer Software is not returnable. Other restrictions may also apply, A Return Authorization is Required for all Prescription Drugs. Simply call cur Customer Service Department `�,1- 800 845 -3550. ENRY SCHEIN SHIP TO: m I Carmel Fire Dept Head Quarters MI 2 Civic Sq Carmel,IN 46032 -2584 135 Duryea Road, Melville, NY 11747 010000130857100219660110010000000035700129084 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 Civic Sq EILL TO INVOICE TOTAL Carmel, IN 46032 -2584 1308571 35.70 INVOICE# INVOICE DATE 219660 -01 1/29/08 CUSTOMER PO# SHIP TO MARK 1308572 Please detach here and mail the above with youcpayment WHSE DEA# Fed ID: 11- 3136595 t r mm z =rs 10 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: HENRY SCHE1q INC. EPT CH 102 1 ALATINE, I 60055 -0241 BILL TO INVOICE INVOIC CUSTOMER PO# ITEM STATUS KEY REM KEY 13 219660 MARK 11 13ackordered: Item will follow SK School Kit HIP T INVOICE DATE F BOXES D Discontinued: Item no longer available NC No Charge P Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/29/08 1 P- Prescription D ug: Return Authorization Rcyuired R Refrigerated Item: May be shipped separately HSI HER Special Schein Pricing 1145220- 1 35.70 2 O F 2 T- Taxable t fly unavailable: please reorder rMH ENRY SCHEIN Matrx Me dical m_., e make ever: effor to ma main Crices for ?e isrrt i �n o` ,Payment by CHECK or by the HENRY SC EIN PLATINUM BUSINESS catalog, h oYYer %ar, we reserti e t he ri 3 to make once. adj u men s in CARGO, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to mariufacture p =rdw Changes YIXK BLL! NM9 NOS Guaranteed Satisfaction: Y� or If you have tried a Prod: and i is defective or does not perform B`Ha d Yo ur sG isfa_c toril e il o r Cvidc a credit, refund, or exchange; !fs v �r n r y:, r n:i p Available to lice nsed practitioners in the US, All invoices are choice. Simpy cal. our cusrorner service aepartrnent 4r,�i h:n 30 days r 0. receipt of the merchandise to arrange for the return. For a pay -a le hlr� 3 nays. arranfy re.;air or if you .ere sent something vllul 7:d not order, simply 0a`I: Rx Products Controlled Substances: latrx Medical -800- 845 -3550 Re ins require its to Ilmrf the sale of Rx and co ntrol ed substances only to reg stere n licensed healthcare profGSS OnasS. f voU are a new customer or !ave recently moved, ukase iurr,'sll us it^: a !'OM' Of year updated state re Fcr c0 ro1!e s r 5`ar�:,es f: rnisn a lrv: %�i of ✓i:r E: A t;ertitica VerltYje io Vo:.ir shipping ^tiiVess. C ;ass l dr gs car! be ordere. ti r., L?: mail, International Carders: Teas Note: :`)e rcud1y scccr,'•e healthcare vo? ess:Ona and cvernments Opened handpieces and equipment may not be returned for .ejt 3 dl ;E ry a ar a, y t hroua hout tha vvor v. To oWe orders ter ftr i eS on export oreu br_ :;li f3 r p it d r ;wplac .i n a0c0rOar) �wi :h rnanufact r sr a ar u,., e r Ce P dr: cs ;r terms and conditions, please contact our interr ati0rai Department 3 f,.�:c r i a han D'ece "Nll prnent, Sl ggeS' `h VOU chic; z t "e shipping coma finer and necking I f tL er €f t that ou have reve yeu exactl ^,hat Prescription Drug Returns Instructions: you orderer. Opened Computer Software is not returnable. other restrictions may also apply, A R?,'U rr:..Autl on7a, ion i s Required f0 a.1 FrescmPtio Drugs. Snoly ;ail ou r 0us Se .0 e D epa e e. �3 g v 3 t n a c ri t^t r: S k LP300 t9 SHIP TO: Matrx Medical Carmel Fire Dept Head Quarters MI INVOICE Carmel,INg46032 -2584 135 Duryea Road, Melville, NY 11747 01000013085710684023011 ,0010000000742500206081 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -2584 BILL TO INVOICE TOTAL 1308571 742.50 INVOICE# INVOICE DATE 6840230 -01 2/06/08 CUSTOMER PO# SHIP TO MARK 1308572 WHSE DEA# Fed ID: 1 3136595 a This order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 175-7 1 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 30 30 C 8.25 247.50 3 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 100 100 4.95 495.00 4 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO I DISCOUNT RECEIPT OR REDEMPTION, 'GU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, TND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSI THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS") CREDIT CARD TO MAK THIS PURCHASE, THEN ANY BENEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCESS OF THOSE BENEFITS TIVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS A DISCO T AN .SIMILARLY DI CLOSED. OUR ORDER 36117425 HAS BEEN SPLIT INTO MULTIPLE SHIPMENTS. CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS TAHEN THEY ARE HIPPED MERCHANDI E TOTAL 742.50 INVOI E TOTAL 742.50 PLEASE PAY WITHIN THIRTY(3 DAYS OF RE EIPT OF THIS INVOICE. 742.50 BILL TO INVOICE4 CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 6840230-01 MARK n Backordered, Item will follow SK School Kit HIP T INVOICE D BOXES D Discontinued. Item no longer available NC -No Charge F Special Schein Tree Goods M Manufacturer will ship Item directly to you 1308572 2/06/08 4 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H Z NUMBER PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 742.50 1 OF 2 T Taxable Item Continued on Next Page.......... WHSE DEA# Fed ID: 11 -3136595 PLEASE NOTE NEW REMIT TO ADDRESS Please remi: payments only to the following a6dress: DEPT CH 10211 PALATINE, 1, 60055-0241 BILL TO INVOICE# CUSTOMER Pnit ITEM STATUS KEY F 1308571 6840230-0 1 MARK 13 Backordered: Item will follow SK School Kit SHIP TO Discontinued: Item no longer available NC No Charge j INVOICE DATE 4 OF BOXES Special Schein Free Goods M Man facturer will ship Item directly to you 1308572 2/06/08 4 P prescription I)mg: Return Authorization Required R Refrigerated Item: May be shipped separately HSI NUMBER INVOICE TOTAL PAGE# SpecU Schein pricing a rnran 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 ♦ae&olneuN mo$ Guaranteed Satisfaction: a If you have tried a product and it is detective or does not perform or sa isfactoril we v. ll rovide a credit, refund, or exchang e; it y ou tl our Order o Yo Opera c ..oun Y. P g x Available to licensed practitioners in the U.S. All invoices are choice. Simply cal our customer service department v,ithin 3v da +,s payable within 30 days, of receipt of the merchandise to arrange for the return. For a warranty repair or if you --ere sent something you did not order, simply call: Rx Products Controlled Substances: 6atrx Medical 800 -845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered licensed healthcare professionals. f you are a new customer or have recently moved, please furnish us with a cope of your updated state registration. For controlled substances, furnish a copy of your DEA certificatte, verifiying your shipping address. Crass it drugs can be ordered only by mail. International Orders: Please Mote: jv %je proudly serve healthcare professionals and governments Opened handpieces and equipment may not be returned for throughout the ..+orid. To place orders or for inquiries on expert credit but .will be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties, Before opening handpieces or 1-800-84- equipment, we suggest that you check the shipping container and pack list to verify that you have received exactly what Prescription Drug Returns Instructions: you urdered.Opened Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all Prescription Drugs. Simply call our Customer Service Department @-800-845-3550, LEI LP300 Prescribed 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)) f Total 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 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members DEPT or INVOICE NO. ACCT #/TITLE AMOUNT I 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 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund