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Home My WebLink About156195 02/06/2008 „f CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $222.50 PALATINE IL 60055 -0241 CHECK NUMBER: 156195 CHECK DATE: 21612008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 6157579 144.50 SPECIAL DEPT SUPPLIES 102 4239011 6443321 78.00 SPECIAL DEPT SUPPLIES WHSE DEA# Fed ID: 11- 3136595 his order has been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751.7 ARK 317-423-8784 1. 420 -4674 EA NASAL ATOMIZATION DEVICE W /SYR 50 50 2.89 144.50 1 HIS PRODUCP IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDIT TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT.OR REDEMPTION, 'IOU ARE RECEI ING OR WILL R CEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSq THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU IIAVE SED A HENR SCHEIN "HS") CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY BENEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCES OF T OSE BENEFITS IVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDISE TOTAL 144.50 INVOI E TOTAL 144.50 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 144.50 BILL TO INVOICE# CUSTOMER 20# ITEM STATUS KEY REM KEY 1308571 6157579-01 MARK HUETT H Backordered: Item will follow SK School Kit Discontinued: Item no longer available NC -No Charge HIP TO INVOICE DATE OF BOXES F Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 1/23/08 1 P- Prescription Drug: Return Authorization Required H I NUMBER INVOICE TOTAL pp g R Refrigerated Item: May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 144. 50 1 OF 2 T Taxable Item Continued on Next Page LP30 WHSE DEA# Fed ID: 11- 3136595 e a A:� his order as been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751-7 1 425 -2520 6 /ST SPLINT VINYL ORANGE 2 2 39.00 78.00 1 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA S "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE NOTICE OF T'E DISCOUNT VALUE. FROM TIME TO TILE, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V UE, D UPON ANY S CH $QUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT kGAINSI THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU IJAVE SED A HENRf SCHEIN "HS CREDIT CARD TO MAKE THIS DURCHASE, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF T OSE BENEFITS TIVEN OR NON —HS DURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. OUR ORDER 55286457 HAS BEEN SPLIT INTO MULTIPLE SHI MENTS. CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE TEMS WHEN THEY ARE HIPPED MERCHANDI E TOTAL 78.00 INVOI E TOTAL 78.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 78.00 BILL TO INVOICE INVOICE# CUSTOMER P ITEM STATUS KEY REM KEY 1308571 6 443321-01 MARK B Backordered: Item will follow SK School Kit SHIP TO INVOICE DATE OF BOXES D Discontinued: Item no longer available NC No Charge F Special Schein Free Goods M Manufacturer will ship Item directly to you 13 08572 1/15/08 2 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 78-00 1 OF 2 T- Taxable Item Continued on Next Page Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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)) 4 x Total I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same inaccordance 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 PO# or DEPT 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 20 o Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund