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Home My WebLink About155754 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $2,101.61 PALATINE IL 60055 -0241 CHECK NUMBER: 155754 CHECK DATE: 1/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467006 6443222 -01 1,551.41 EMS EQUIP 102 4239011 6607477 -01 175.20 SPECIAL DEPT SUPPLIES 102 4467006 6607482 -01 375.00 EMS EQUIP Eli WHSE DEA# Fed ID: 11- 3136595 1 102 -3874 EA ULTRA LOC BACKBOARD YELLOW 3 3 125.00 375.00 PRODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAIUFACTERER. 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 r RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSI THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENRC 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 GIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANF SIMILARLY DI CLOSED. OUR ORDER 55309645 HAS BEEN SPLIT INTO MULTIPLE SHI MENTS- CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS WHEN THEY ARE HIPPED MERCHANDI E TOTAL 375.00 INVOI E TOTAL 375.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 375.00 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI 4 INC. DEPT CH 10211 ALATINE, I 60055 -0241 BILL To INVOICE4 CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 G607482-01 MARK 13 -Backordered; Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge HI T INVOICE DATE F XE I' Special Schein Free (foods M Manufacturer will ship Item directly to you 1308572 1/09/08 P- Proscription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately HSI NUMBER I E AL PA E Special Schein Pricing 114152220— 1 375.00 1 O F 1 T- Tax ble Ite unavailable: please reorder LP 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 Yaw Bwl u W ate rsz� V/ r: •6 Guaranteed Satisfaction: b If you have tried a product and it is defective or does not perform or satisfactorily, we will provide a credit, refund, or exchange; its your Bill Your Order To Your Open Account choice. Simply call our customer service department within 30 days Available to licensed practitioners in the U.S. All invoices are of receipt of the merchandise to arrange for the return. For a payable 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 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 II drugs can be ordered only by mail. International Orders: Pleas Note: 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 warranties. Before opening handpieces or terms and conditions, please contact our International Department: equipment, we suggest that you check the shipping container 1-800- 845 -3550 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 cal! our Customer Service Department 1- 800 845 -3550. dt- r; WHSE DEA# Fed ID: 11- 3136595 My, e o ,xe� his order ias been processed by our NORTHEAS D.C. 41 WEAVEK ROAD DENVER, A 17517 1 827 -2329 EA' SUCTION UNIT W /DISP CANN 1 1 C 645.55 645.55 1 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 2 600 -4070 1 /KT I/ LARYGOSCOPE ASST BLADE KIT 3 3 82.82 248.46 4 3 891 -5261 EA ACCU -CHEK ADVANTAGE CARE KIT 2 2 64.70 129.40 4 4 387 -2214 EA, KENDRICK EXTRACT DEVICE K.E.D. 1 1 C 103.00 103.00 2 ASE GOOODD I EM, MAY BE SHIPPED SEPARATELY. 5 672 -4224 EA FERNOTRAC SPLINT ADLT &PED 441 1 1 C 395.00 395.00 3 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 6 499 -0593 EA V EMS SHEARS RED 12 12 2.50 30.00 4 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURC 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 RECEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, 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 DI COUNT GAINS THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RE ORDS. IF YOU VE ILL TO INVOICE14 CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 6443222-01 MARK It Backordered: Item will follow SK School Kit P TO INVOICE D F BOXES D Discontinued: Itcm no longer available NC -No Charge ATE P Special Schein Free Goods M Manufacturer will ship Item direct]% to you 1308572 1/03/08 4 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBE Special Schein Pricing u Temporarily unavailable: please reorder 114S220- 1 1551.41 1 OF 2 T Taxable Itum Continued on Next Page *xsaocA# Fed ID: n-3/sanm rhis order ias been processed by our NORTHEAS- D.C. 41 WEAVEZ ROAD DENVER, PA 175L7 STEM II 1200C 1 116-9264 EA SEP-T-VAC SYSTEM II 1200C 48 48 C 2.70 129.60 1 C AS GO< L, ON TUBING 9/3211 2 499-0789 EA SUCTI STERIL 48 48 0.95 45.60 2 F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G., POINIS, GIFTS OR OTHER PECIAL AWAZDS ("DISCOUNT")), WITH THIS PURCli�SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE.:N ACCOZDANCE WITH DISCOUNT PROGRAM NOTICE OF TiE DISCOUNT VALUE. FROM TIME TO TIlE, MEDECARE, MEDICAID, TRI-ARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VkLUE, PND UPON ANY STCH REQUEST, SU--H VALUE MUST BE DISCLOSED AS A DI3COUNT AGAINSI THE PURCHASE!; THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE'AIN THESE RECORDS. IF YOU WAVE JSED A HENR� SCHEIN ("HS") CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY B NEFITS ROM PURCHA3ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF TFOSE BENEFITS TIVEN OR NON-HS PURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANI SIMILARLY DISCLOSED. OUR ORDER 35309645 HAS BEEN SPLIT INTO MULTIPLE SHIPMENTS. CERTAIN ITEM!, WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ETEMS WHEN THEY ARE XHIPPED MERCHANDI E TOTAL 175.20 INVOI E TOTAL 175.20 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 175.20 BILL TO INVOICE# CUSTOMER PQ# EY REM E ITEM STATUS KEY LIK-_�Sc�.�Ku 1308571 .6607477-01 MARK B Backordered: Item will follow 1) Disconjnucd� item no lon available NC No harge SHIP TO INVOICE DATE OF BOXES F Special Schein Free Goods Isl Manufacturer will ship item directl to y ou 1308572 1/04/08 2 11 Prescription Drug: Return Authori72tion Required R Refrigerated Item: May be shipped separatel HSI NUMBER INVOICE TOTAL PAGF# Special Schein Pricing U Temporarily unavailable: please reorder Co N ext R HENRY SCHEIN SHIP TO: Matrx Med VOIC I� Carmel Fire Dept Head Quarters MI 2 Civic Sq Carmel,IN 46032 -2584 135 Duryea Road, Melville, NY 11747 0100001308571064432221 ,10010000001551410103086 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 1551.41 INVOICE# INVOICE DATE 6443222 -01 1/03/08 CUSTOMER POlt SHIP TO MARK 1308572 Please detach here and mail the above with your payment WHSE DEA# Fed ID: 11- 313659 Is, .f .3 ,c. SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS DURCHAEE, THEN ANY BENEFITS F ROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF THOSE BENEFITS TIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. OUR ORDER 55286457 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE TEMS WHEN THEY ARE HIPPED MERCHANDI E TOTAL 1551.41 INVOI E TOTAL 1551.41 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1551.41 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102 1 E?LL:'I'iNG, 1 6iiu55 u2 i1 BILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 6443222-01 MARK It Backordered: Item will follow SK School Kit HIP T E DATE p Discontinued: Item no longer available NC -No Charge P Special Schein 1 Goods M Manufacturer will ship Item directly to you 13 0 8 5 7 2 1/03/08 4 1' Prescription Dmg: Return Authorisation "Required R Refrigerated Item: May be shipped separately IISI MIMBER INVOICE Special Schein Pricing 1145220- 1 1551.41 2 OF 2 T Taxable I� m y unavailable: please reorder i. Matrx Medical 3 t L R- N O F A-L F r Payment by CHECK or y the HENRY S HEfN PLATItIt1 BUSINESS e make every affort to maintain prices for the duratior o" a r4 catalog, however, e reserve the right to make price adjustments in CARS?, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to anufactu°„ pric4 changes 4 Guaranteed Satisfaction: w or It you have tried a product and It is detective o does not perorm r t i o ur Open sa lsfactorily, e w provide a credit, refund, or ;exchange; it' roar cntoica. Si v call our custom :r service cepartment within 3) flays Available a licensee pract in the i .S. All invoices are of receipt of the merchandise to arrange for the return. For a payaule in 33 dar5. I warranty repair or if you were sent something you did not order, simply call: x Products Controlled Substances: Matrx Medical -800- 845 -3550 R eguilations, require us to limit the sale of Fx an^ control eu suu only to r g Ster?d, licensed healthcare urefess ona s. t you are a rl-w customer c:r ha�fe recently moveed, please furry sh us im a couyr of your updated state redoation. For controlied su ,stances, €urnish a copy of your r DiEA ceitificat verity' Vn 1r shipping address. Class ll drugs can be ordered= only by mail. International Orders: Please Dote: ;fie .rC it71y Serve hea thcare pro YeSStGriatS aril gover Men-5 Opened handpiece and e :U;rMent rapt not ll- re °urned for t ignou tlr o. o p Yips on expert 11 iedl` bu Ya`iIl tae reoaired ,laced iii am. a'lCe vviih fro orl lace orders o. to it �u,:. rrm. ;tw t,>n :ttrind• pe C E l,tll ;[a mir'nternt -dorsal Deoartr��:nt. mar UtaGtt r`'` ?ar'an S. Befo' orenino hand> or n equipment, fete suggest t,1at you check, the, shipping container and packing list to verify that you have received exactiy .lylhat you ordered.Opened Computer Software is not returnable. Prescription Drub Returns Instructions: s: Other restrictions may also apply. A Fieiurr Nutt clf3?ai is rieGulred for ail Prescrip Uruas. S ca ll our Customer Seyce Deparr 0 1 800 -345- 35503. s Lia 3 91 p LP300 PreK:ribed 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)) o 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 x•0055 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 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 0 r— i ure Cost distribution ledger classification if Title claim paid motor vehicle highway fund