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Home My WebLink About155328 01/10/2008 (91 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $135.00 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 155328 CHECK DATE: 1110/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 1884607 -01 135.00 SPECIAL DEPT SUPPLIES a WHSE DEA# Fed ID: 11- 3136595 NP �ZZ _3�Sazr qaR stir r his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, PA 1751_7 VIA RK 317-423-8784 CELL 1 231 -0453 PU 100 /BX SALINE FLUSH SYRINGE .90 10ML 3 3 45.00 135.00 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDIII TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, COU ARE RECEI ING OR WILL RECEIVE I I OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORRJATI: -N REGARDING SUCH 'v LUE, ND UPON ANY LITCH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU 1AVE SED A HENR SCHEIN "HS") CREDIT CARD TO MAKE THIS URCHA E, THEN ANY B NEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCESS OF T OSE BENEFITS IVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 135.00 INVOI E TOTAL 135.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 135.00 BIL TO INVOICE INVOICE# CUSTOMER PQ# ITEM STATUS KEY REM KEY 1308571 1884607-01 MARK B Backordered: Item will follow SK School Kit S HIP T INVOICE g D Discontinued: Item no longer available NC -No Charge Special Schein Pree Goods M Manufacturer will ship Item directly to you 1308572 12/21/07 1 P Prescription Drug: Return Authorivation Required R Refrigerated Item: May be shipped separately H BER INVOIrE TOTAL PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220— 1 13 5. 0 0 l O F 2 T- Taxable Item Continued on Next Page F SHIP TO: i I A Carmel Fire Dept Head Quarters MI 2 Civic Sq Carmel,IN 46032 -2584 135 Duryea Road, Melville, NY 11747 01, 0000130857101, 88460711001 ,00000001135001221071 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 135.00 INVOICE# INVOICE DATE 1884607 -01 12/21/07 CUSTOMER PO# SHIP TO MARK 1308572 Please detach here and mail the above With your Payment- WHSE DEA# Fed ID: 11- 3136595 r y zra /ay .Y 0 e a t �s� =,3" 3.. tt 5 �,pp 'a•_ x �a ys5✓ g e '�i, t 43, LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following address: HENRY SCHEIi INC. EPT CH 10211 ALATINE, I 60055 -0241 Blii To INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 130 18846 MARK 13 Backordered: Item will follow SK School Kit T INVOICE DATE E D Discontinued: Item no longer available NC No Charge SHIP F- Special Schein Free Goods M Manufacturer will ship Item directly to you 13 0 8 5 7 2 12/21/07 1 P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately x i JM BER Special Schein Pricing 1145220 1 135.00 2 O F 2 T- Taxable Item please murder m HENRY SCHEIN TERMS OF S' ALE Matrx 1 r�Je make ever; effort to maintain prices for the d:�ration of a Payment by CHECK or by the HENRY SCHEIN PLATINUM BUSINESS catalog, however, she reserve the right to make price adjustments in CARD, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes wBmf Ntm F3 CiY �glf� Guaranteed Satisfaction: vrsa x ;i It you have tried a pr and it is defective or does not perform or It. rcierrr A satisfactorily, we will provide a credit, refund, or exchange; it's your Available to licensed practitioners in the EJ.S. All invoices are choice. Simply call our customer service department within 30 days payable within 30 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; Matra 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 DcA certificate verifying your shipping address. Class it drugs can be ordered only by mail. International Orders; Please Note: 'rle proudly serve healthcare professionals and governments Opened fEa ,dpieces and equipment may not be returned for throughout the World. To place orders or for inquiries on export credit bu:.1�'Ell be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer ,varranties. Before opening handpieces or 1-800-84 5-35 50 equipment, we suggest 'hat you check the shipping container and packing list to verify that you have received exactly :;'hat 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 call our Customer Service Department 800 -845 -3850. L 72k LP300 Prescribed by State Board of Accounts J City Form No. 201 Rev. 1995 ;t. 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)) 4 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 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 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund