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Home My WebLink About160382 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 0 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $3,925.04 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 160382 CHECK DATE: 6/10/2008 DEPARTMENT ACCOUNT PO NUMBER INVO NUM BER AMOUNT DESCRIPTION 102 4239011 1127069 -02 118.15 SPECIAL DEPT SUPPLIES 102 4239011 1227069 -03 55.60 SPECIAL DEPT SUPPLIES 102 4239011 3724890 -01 239.52 SPECIAL DEPT SUPPLIES 102 4467007 5960715 -01 3,511.77 TRAINING EQUIPMENT r WHSE DEA# Fed ID: I1- 3136595 v`,� -s'� <�3 s ue l E „ru „.ca.ufc 4 499 -2476 EA RESCUE RANDY 145LB 2 0.00 0.00 P RODUCT IS SING SHIPPED TO YOU DIRECTLY FROM THE MAZUFACT RER. 5 499 -9883 EA DELUXE CASUALTY SIMULATIO 1 1 552.00 552.00 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTLRER. 6 499 -2154 EA EMT CASUALTY SIM KIT 1 1 737.05 737.05 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAiUFACTLRER. 7 686 -9701 4 /PK PNEUMOTHORAX PAD 1 1 18.20 18.20 P RODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE MAITUFACTLIZER. 8 799 -8224 EA INJECTION SITE F /IV ARM 1 1 27.09 27.09 P RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MA4UFACTLRER. 9 .499 -3223 EA POWDER F /SIMULATED BLOOD 1 1 11.28 11.28 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAFUFACTLRER. 10 429 -0804 EA IV VEIN KIT REPLACEMENT 1 1 9.05 9.05 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE FACT RER. 11 499 -0946 EA CARRY CASE 3 0.00 0.00 P RODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE M UFACT RER. 12 499 -1018 EA IV RESERVOIR BAG 1 1 7.82 7.82 P RODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE M FACT RER. 13 839 -6649 EA TEETH REPLACEMENT SET 1 1 24.90 24.90 P RODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE MAIUFACTILRER. BILL To INVOIC CUS TOMER PO# ITEM STATUS KEY REM KEY 1308571 5960715-01 MARK HUI ETT n Backordered: Item will follow- SK School hit HIP T INVOICE ATE 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 6/02/08 P- Prescription Drug: Return Authorization Required R Reftigerated Item: May be shipped separately H I BER INVOICE TOTAL PAGE4 Special Schein Pricing 1145220- 1 3S11.77 2 O F 4 T- Taxable Item unavailable: please reorder Continued on Next Page i WHSE DEA# Fed ID: 11- 3136595 $'d °'�R'°� n>•c,��.Eyf'�.. %'.l'PdID 14 499 -4063 EA OVERLAY- TEACHING SKIN 1 0.00 0.00 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MATUFACTLRER. 15 499 -4064 EA MANUAL DIFIB. ADAPTERS 1 1 28.61 28.61 P RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MATUFACTIRER. 16 466 -6986 1 IV REPLACEMENT SKIN 1 0.00 0.00 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAqUFACTCRER. 17 738 -9314 EA CRICO REPLACEMENT SKIN 1 1 18.20 18.20 P RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MAqUFACTLRER. 18 499 -4065 EA K -Y LUBRICANT 1 1 1.69 1.69 P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAqUFACTLRER. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE 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, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, IND UPON ANY S CH R 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 VE SED A HENRr SCHEIN "HS CREDIT CARD TO MAKs THIS DURCHAEE, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IJ EXCES3 OF T OSE BENEFITS TIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 3511.77 BILL TO INVOIC CUS TOMER PO# ITEM STATUS KEY REM KEY 1308571 5960715-01 MARK HU I E TT 13 13ackordercd: Rcm will Colo- SK School Kit D Discontinued: Item no longer available NC No Charge HIP T INVOICE DATE F BOXES P Special Schein Free Goods M Manufacturer will ship Itcm directly to you 1308572 6/02/08 1' Prescription Drug: Return Authorization'Required R Refrigerated item: May be shipped separately H I BER Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 3511.77 3 OF 4 j T Taxablehm Continued on Next Page.......... WHSE DEA# Fed ID: 11-3136595 O W "M "TWI MA�� 2 w0am INVOIWE TOTAL 3511.77 PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS INVOICE. 3511.77 PLEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following aldress: HENRY SCHEIq INC. DEPT CH 10211 PALATINE, I 60055-0241 BILL.TQ INVOICE TOMER Po ITEM STATUS KEY REM KEY 1308571 5960715-01 MARK HUIETT 13 Backordered: Item will follow SK School Kit SHIP TO INVQICF DATE OF BQX7' 1) Discontinued: Item no longer available NC No Charge F- Special Schein Free Goods M Nianufactuier will ship Item directly to you 1308572 6/02/08 P Prescription Drug: Return Aulhorization Required R Retri2craied Item: May be shipped separately H NUMBER INVOI(E TOTAL PAGE# Special Schein Prime U Temporarily unavailable: please reorder 1145220- 1 3511.77 4 OF 4 T Taxable Item ';Ye make every effort to maintain ,prices for 'he cluiration of a Payment by CHECK or by the HENRY SCHEIN PLATINUM BUSINESS Cataloo, however, we reserve the right to maKeorice adjus'mem's in CARD VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response ro manufacturers price changes Guaranteed Satisfaction: or If you have tried a, nrodud and is -defective or does not pedorn", I 6j" You, '-'?-der 1k. Opu n kc sanslactorily, vv will vide, acreClfit, refund, or excilhange its your Avaiiab;leto licensed pract:tioners in the U3, All invoices are Choice, Sirir)"vcaf'oL. ri:ri 3r� d-,ivs v n of receipt of the, merchandise to arrange for the return. Fora payable odhin 3 days. —arrantv errair o r r you were sent something you did not order simply call: Rx Products Controlled Substances: Matrx Medical 1-800-845-3550 Reaulations require us to limit the sale of Rx and control,ed suostances only to registered, licensed healthcare profess:,onazs. It you are a ne VIV customer or have recently moved, Please f I i S t j us wim, a coon of your updated staine reoistration. For controlled subInrices, furnish a copy of your D M A certiticate, verifying your shipping. address. Class ll drugs can be ordered only by mail, International Orders: Please Note: v'e he"alt'hoare pro`ers. and y ovar mrnens Opened handpiecess and equipment may not be returned for throughout the Wor''. To place orders or for inquiries on export edi-,, but .vile be repaired or replacedir� ac-Dor.ance with terms and conditbns, please contact our International Depariment: manufacturer viar es. Before opening handpieces or 11-800-845-H-0 equipment, w an e suavest hat vou check the shipping container and oacking list to verity that you have received exactly what y Prescription Drug Returns Instructions: you ordered.0pened 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 -8000-845-3550 LP300 WHSE DEA# Fed ID: 11- 3136595 his order ias been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 1 463 -0952 EA SAM SPLINT ORNG 5.5X3/16" X -LARGE 8 8 6.95 55.60 1 F YOU ARE 3ARTICIPATING 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 S PRVICES, RECEIVABLE OR REDEEMABLE N ACCO ZDANCE WITH DISCOUNT PROGRAM RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE 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, PND UPON ANY SUCH EQUEST; H VALUE MUST BE DISCLOSED`AS DI COUNT 5,GAINSI THE PURCHASE THAT EARNED 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 IN EXCES3 OF T OSE BENEFITS IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 55.60 INVOI E TOTAL 55.60 PLEASE PAY WITHIN THIRTY0 DAYS OF RECEIPT OF THIS NVOICE. 55.60 BILL TO INVOICEft CUSTOMER P ITEM STATUS KEY REM KEY 1308571 1227069-03 MARK a Backordered: hem will follow :1K School Kit HIP INV I E DATE F B XE D Discontinued: Item no longer available C No Charge P Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 5/20/08 1 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately BER INVOICE TOTAL Special Schein Pricing U Temporarily unavailable: please reorder 1 1 -5-5.60 l OF 2 T- Taxable hem Continued on Next Page LP WHSE DEA# Fed ID: 11- 3136595 P a w u3 his order as been processed by our MIDWEST U.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 1 463 -0952 EA SAM SPLINT ORNG 5.5X3/16" X -LARGE 25 17 6.95 118.15 1 ARTIAL SHI MENT WILL SHIP AND INVOICE WHEN AVAILABLE. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR 0 HER PECIAL ANA DS "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. UPO DISCOUNT RECEIPT OR REDEMPTION, 'IOU 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, PND UPON ANY S CH R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT kGAINSI THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU AVE U SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS F ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS IVEN OR NON —HS URCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 118.15 INVOI E TOTAL 118.15 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 118.15 13 T TL TO INVOICE# CUS TOMER PO# ITEM STATUS KEY REM KEY 1308571 1227069-02 MARK H Ba&orderud. Item will follow sx Schorr Kit D Discontinued: Item no longer available NC No Charge HIP T INVOICE DATE OF BOXES F- Special Schein free Goods M Manufacturer will ship Item directly to you 13 08572 5/20/08 1 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER INVOICE TOTAL PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 118.15 1 1 OF 2 T- Taxable Rem Continued on Next Page L-P300 WHSE DEA# Fed ID: 11- 3136595 ,MN his order ias been processed by our NORTHERS D.C. 41 WEAVER ROAD DENVER, A 175 7 1 891 -3037 PU 50 /CA IV PREP KIT W/ TEGADERM 4 4 C 59.88 239.52 4 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 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 CREDZ TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEIIvING OR WILL RECEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSI THE PURCHASET THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE USED A HENP. SCHEIN "HS CREDIT CARD TO MAKI THIS DURCHASE, THEN ANY B NEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD Il EXCES3 OF THOSE BENEFITS IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 239.52 INVOI E TOTAL 239.52 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 239.52 BILL TO INVOICE# CUSTOMER PO4 ITEM STATUS KEY L l EM KEY 1308571 3724890-01 MARK HU I E TT B Backordered: Item will follow School Kit Discontinued: Item no longer available No Charec HIP T INVOICE DATE OF BOXES P- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 5/20/08 4 F- lNcscription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately INVOICE TOTAL PAQF# H BER Special Schein Prieine U Temporarily unavailable: please murder 1145220- 1 239.52 1 OF 2 T Taxable Item Continued on Next Page WHSE DEA# Fed ID: 11- 3136595 v y/r, �/gxx z. r %`..i s ri., a UOTE DATED 05 -13 -08 f JULIE BAKER 800-845- X328 APPROVED RDERED BY MARK HULETT 17 -571 -266 17 -571 -261 17- 428 -878 1 608 -2408 EA PDA STAT ADULT TRAINER 1 0.00 0.00 AIL 1-800-131-4310 SPECIA APPROVAL XTRA ITEMS APPROVED TO GO WITH PDA STAT 101- 00 PER GAI RE AS FOLL WS: (03 -26 -08 FOR THIS QUOTE ONLY TOMACH 145 QTY 1 UNGS 902 QTY 1 EMBRANE TA E PP0283 QTY 1 YRINGE PPO 161 QTY 1 YRINGE PPO 105 QTY 1 i JULI BAKER 1 -800- 845 -3550 X328 LEASE CALL JULIE SHOULD YOU HAVE ANY QUESTIO S HANK YOU Ii ADVANCE JB ULIE.BAKER_HENRYSCHEIN.COM PRODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE FACT RER. 2 499 -1017 EA RESCUE RANDY COMBAT CHALL 165LBS 1 1 885.88 885.88 PRODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE M FACT RER. 3 499 -2446 EA RESCUE RANDY 55LBS 2 2 595.00 1190.00 PRODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MAJUFACTLRER. BILL, TO INVO ICE# CUS TOMER PO# ITEM STATUS KEY REM KEY 1308571 596071S-01 MARK HUI ETT It Backordered: Item will tallow SK school Kit HIP T INVOICE DATE F BOXES P Discontinued: Item no longer available NC No Charce P Special Schein Pe Goods M Manuf re acturer will ship Item directly to you 1308572 6/02/08 P- Prescription Drug: Return Auihomation Required R ReGigerated Item: May be shipped separately HSI NUMBER Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 3511.77 1 OF 4 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)) 05/20/08 3724890 -01 EMS Supplies $239.52 05/20/08 1127069 -02 EMS Supplies $118.15 05/20/08 1227069 -03 EMS Supplies $55.60 06/02/08 5960715 -01 Manikins $3,511.77 1 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. W NO. Henry Schein ALLOWED 20 IN SUM OF Dept Ch 10241 Palatine, IL 60055 $3,925.04 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 3724890 -01 102- 390.11 $239.52 1 hereby certify that the attached invoice(s), or 1120 1127069 -02 102 390.11 $118.15 bill(s) is (are) true and correct and that the 1120 1227069 -03 102 390.11 $55.60 materials or services itemized thereon for 1120 5960715 -01 102 670.07 $3,511.77 which charge is made were ordered and received except .0/1 %1- Title Cost distribution ledger classification if claim paid motor vehicle highway fund