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Home My WebLink About159910 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 0 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,305.77 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 159910 CHECK DATE: 5/28/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A D ESCRIPTION 102 4239011 1148573 -02 10.50 SPECIAL DEPT SUPPLIES 102 4239011 1345717 -01 112.97 SPECIAL DEPT SUPPLIES 102 4239011 219848 -01 63.00 SPECIAL DEPT SUPPLIES 102 4239011 5954789 -01 207.00 SPECIAL DEPT SUPPLIES 102 4239011 873009 -01 129.60 SPECIAL DEPT SUPPLIES 102 4467006 873009 -01 782.70 EMS EQUIP WHSE DEA# Fed ID: 11- 3136595 mom his order ias been processed by our NORTHEAST D.C. 41 WEAVER ROAD DENVER, PA 1751-7 1 221 -3973 3 /PK GLUCOBURST GLUCOSE GEL 15GM 2 2 5.25 10.50 1 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR O HER PECIAL AWA DS "DISCOUNT WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO 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 SITCH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSU THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RE ORDS. IF YOU AVE 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 I EXCES3 OF T OSE BENEFITS 0IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDI E TOTAL 10.50 INVOI E TOTAL 10.50 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 10.50 BILL TO INVOICE INVOICF# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 1148573-02 MARK s Backordered; hem will follow SK School Kit D Discontinued: Item no longer available NC- No Charge S HIP TO INVOICE DATE OF BOXES F Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 5/09/08 1 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 1145220- 1 10.50 1 OF 2 T Taxable Item Continued on Next Page L VUUU WHSE DEA# Fed ID: 1 1- 3136595 g i rt 05 n c 3w,, #m v PRODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTLRER. F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA S "DISCOUNT WITH THIS PURCHASE 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, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, AND 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 RETAIN TH SE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS DURCHASE, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS TIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. OUR ORDER 8022917 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. "CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS 1AHEN THEY ARE HIPPED MERCHANDI E TOTAL 207.00 INVOI E TOTAL 207.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS :NVOICE. 207.00 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 TO INVOICE# CUSTOMER PO4 ITEM STATUS KEY REM KEY 13 5954789- MARK It Backordered: Item will follow SK School Kit D Discontinued: Item no longer available NC No Ch ,re HIP TO INVOICE DATE OF BOXES F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 5/12/08 P- Prescription Drug: Return Authorization Required R Refrigerated Item: 1,1ay be shipped separately HST BER Special Schein Pricine U Temporarily unavailable: please reorder 1145220– 1 207.00 2 OF 2 T Taxable Item Ne make 8vepv effor, to maintain prices for the du.rallionofa Pa ment by CHECK or by the HENRY SCHEIN PLATINUM BUSINESS u�abg.hnwavu�wneoems��hg��n�k p��m�us�na�oin CARD, VISA, MASTERCARA DISCOVER and AMERICAN EXPRES9 response iomanufacture,rz 'phcmchanges VW i Guaranteed Satisfaction: or |fynu have tried apmduc1 and itis defective or does no',perform Bill You 0�-der "k- _�,xir Open Ac:�oun!' aa ml. provide omedii. refund, orexohonge it's your Available m licensed pract:tioners in the Uc All invoces arc- ohoi:e. Simp� call ourou��mersomioedopa�mentwihin8Odeya pavable within 3,n days, o' receipt of the merchandise to arrange for the r turn, Fora �enantym�k you viem sent nmmethingyoudi�n�o�er. simply Rx Products Controlled Substances: Matrx Medical 1-800~845-3550 ReOo|odooS rquire us to limit the oaleofRx and nnntm|!ed oubstanceoon|ytu registered, licensed heaNhcarepm�_os:nn8|a. |i you are u new customer urhavereoanUy moved, please iumiah Lis with u copy of i i Fo uonrd|ed substunoea.fumiahu co py of yourDEAoeli5nsia, verifying ynur shipping address, C|aas({druQa can. bo ordered on|ybymail. International Orders: Please Note: VVe proudly serve hea|thoarepmfeoninna|u and govemments Opened handpieces and equpment may not berefirned fo throughout the wod�, To Place orders urinrinquiheuon exriort u�m/�.uu'�n'ue repai v/.ep/^xevx' accordance w terms and condihono. please ooniuxt Our International DepaMment: manufacturer ,,o'." ..vBefo="p='i h andD.'eCeS Or 1'800'845'3550 equ ipmerit 10le u ggeet'hat you checkthe shipping container and p*cKmg l ist m veri that you have rece exac what Prescription [�ru��eKurn8InstyUciions' ;ouo�e�dO Computer erSo� returnable. Otherreetrintimns may also apply. A Return Authorization ia Required for a||Pmoc Drugs, Simp|yca}| uurOus toma/SouiceD�mriunen Lp3oo WHSE DEA# Fed ID: 11- 3136595 his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751-7 1 666 -2575 EA SHARPS CONTAINER 2GAL 20 20 C 3.15 63.00 1 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA S "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, yOU ARE RECEI ING OR WILL RECEIVE 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, IND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT kGAINS1 THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU ILAVE SED A HENRC SCHEIN "HS CREDIT CARD TO MAK THIS PURCHASE, THEN ANY BENEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCES3 OF T OSE BENEFITS TIVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 63.00 INVOI E TOTAL 63.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 63.00 BILL TO INVOICE# CUSTOMER P ITEM STATUS KEY REM KEY 1308571 219848-01 MARK 13 Backordered: Item will follow SK School Kit D Discontinued: Item no longer available Nc No Charge SHI TO INVOICE DATE 4 OF BOXES F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 5/13/08 1 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I B R INV I T PA E Special Schein Pricing U Temporarily unavailable: please reorder 114 5 2 2 0- 1 63 .0 0 1 OF 2 T- Taxable Item Continued on Next Page L WHSE DEA# Fed ID: 11- 3136595 1 109 -9532 25 /CA TYVEK COVERALL W /HOOD LARGE 1 1 112.97 112.97 PRODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE MANUFACT RER. F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (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 ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOR DISCOUNT RECEIPT OR REDEMPTION, OU 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, PND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINS THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY B NEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD Ila EXCES3 OF, T OSE BENEFITS, IVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 112.97 INVOI E TOTAL 112.97 PLEASE PAY WITHIN THIRTY(30) DAYS OF RECEIPT OF THIS NVOICE. 112.97 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. DEPT CH 102 1 ALATINE, I 60055 -0241 BILL TO INVOICE# C11STOMER PO# ITEM STATUS KEY REM KEY 1308571 1345717-01 MARK 05-02-08 s Hackordered: Item will follow SK School Kit 1) Discontinued: Item no longer available NC No Charge S HIP TO INVOICE DATE OF BOXES F- Special Schein Free Goods M Manufacturer will ship Item directly to you 13 0 8 5 7 2 5/14/08 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NMBER INVOICE TOTAL PAGE Special Schein Pricing U Temporarily unavailable; please reorder 1145220— 1 112.97 1 OF 1 T Taxable Item 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 i� R y� Guaranteed Satisfaction. If ou have tried a product and it is detective or does not perform or satisfactorily, we will provide a credit, refund, or exchange; it's your Bill Y our Order To Your Open Account choice. Simply call our customer service depa tment within 30 days Available to licensed practitioners in the U.S. All invoices are of receipt of the merchandise to arrange for the return. Fora 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 11 drugs can be ordered only by mail. International Orders: Please N Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governments throughout the world. To place orders or for inquiries on export credit, but will repaired e replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties. rranties. 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.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 1- 800 -845 -3550. WHSE DEA# Fed 1D: 11- 3136595 I his order has been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, PA 1751-7 RK 317-57L-2663 17- 428 -878 1 338 -2276 PU 100 /CA EXTENSION SET STD BORE UL 3 3 C 260.90 782.70 3 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 258 -9850 250ML /BT STERILE WATER F /IRRIG 96 96 C 1.35 129.60 7 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE ARTICIPATING IN DISCOUNT PROD (E.G. POIN S, GIFTS OR O'HER 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, 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 VALUE, PND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSq THE PURCHASE THAT EARNED 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 THOSE BENEFITS TIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDI E TOTAL 912.30 INVOI E TOTAL 912.30 BILL To IYVQICE# CUSTOMER POtf ITEM STATUS KEY REM KEY 1308571 873009-01 MARK HUE I TT N Backordered: Item will follow sK school Kit D Discontinued: Item no longer available NC No Charge SHI TO INVOICE DATE OF BOXES P Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 S/14/08 7 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately ESI NUMBER Special Schein Pricing U Temporarily unavailable; please reorder 1145220— 1 912.3 0 1 OF 2 T Taxable Item Continued on Next Page SHIP TO: Matrx Medical 2 Civic Carmel Fire Dept Head Quarters MI I NV OICE Carmel,INg46032 -2584 135 Duryea Road, Melville, NY 11747 0100001308571, 0595478911 1001000000020700051,2086 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 207.00 INVOICE# INVOICE DATE 5954789 -01 5/12/08 CUSTOMER PO# SHIP TO D4ARK 1308572 WHSE DEA# Fed ID: 11-3136595 4 fib i .e'a;t ,a fi ryr I gift" �i„ .,..H-< .yig:� a �?ts,° ._...?x< n n� _,�..�e 5... s..:�.ntW RK 317-57L-2663 1 499 -3769 10 /BX CUFFED ET TUBE 9.0, 2 2 11.50 23.00 LEASE SHIP ASAP IF YOU HAVE ANY QUESTIONS OR IF TEMS RE BACKORD RED PLEASE CALL JULIE BAKER 1-800-84 RODUCT IS EING 35 0 X32 HANK YOU SHIPPED TO YOU DIRECTLY FROM THE UFACT RER. 2 499 -3768 10 /BX CUFFED ET TUBE 8.5, 2 2 11.50 23.00 RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MARUFACT RER. 3 499 -3767 10 /BX CUFFED ET TUBE 8.0 2 2 11.50 23.00 RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE M UFACT RER. 4 499 -3766 10 /BX CUFFED ET TUBE 7.5, 2 2 11.50 23.00 RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTURER. 5 499 -3765 10 /BX CUFFED ET TUBE 7.0, 2 2 11.50 23.00 RODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE MATUFACT111RER. 6 '499 -3764 10 /BX CUFFED ET TUBE 6.5, 2 2 11.50 23.00 RODU IS.-BEING-SHIPPED TO YOU DIRECTLY FROM THE MATUFACTLRER. 7 499 -3763 10/EX CUFFED ET TUBE 6.0, 2 2 11.50 23.00 RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MAFUFACTLRER. 8 499 -3762 10 /BX CUFFED ET TUBE 5.5, 2 2 11.50 23.00 RODUCT IS SING SHIPPED TO YOU DIRECTLY FROM THE MARUFACTLRER. 9 499 -3752 10 /BX CUFFED ET TUBE 5.0, 2 2 11.50 23.00 BILL TO INVOIC CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 S954789-01 MARK 13 Backordered: Item will follow L S K School Kit HI T INVOICE DATE F BOXES D Discontinued: Item no loneer available Charee P tipecial Schein Pree Goods M Manufacturer will ship Item directly to you 1308572 5/12/08 P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately H I NUMBER INV tipecial Schein Pricing U Temporaril unavailable: please reorder 1145220- 1 207.00 1 OF 2 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)) 873009 -01 EMS Equipment $782.70 1148573 -02 EMS Supplies $10.50 5954789 -01 EMS Supplies $207.00 219848 -01 EMS Supplies $63.00 1345717 -01 EMS Supplies $112.97 873009 -01 EMS Supplies $129.60 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. Henry Schein ALLOWED 20 IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,305.77 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 873009 -01 102- 670.06 $782.70 1 hereby certify that the attached invoice(s), or 1120 1148573 -02 102 390.11 $10.50 bill(s) is (are) true and correct and that the 1120 5954789 -01 102- 390.11 $207.00 materials or services itemized thereon for 1120 219848 -01 102- 390.11 $63.00 1120 1345717 -01 102 390.11 $112.97 which charge is made were ordered and 1120 873009 -01 102 390.11 $129.60 received except r Title Cost distribution ledger classification if claim paid motor vehicle highway fund