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Home My WebLink About159384 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 y0� ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,496.95 CARMEL, INDIANA 46032 DEPT CH 10241 ti�on PALATINE IL 60055 -0241 CHECK NUMBER: 159384 CHECK DATE: 5/14/2008 DEPARTMENT A CCOUN T P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION ,'102 4239011 1148573 -01 90.75 SPECIAL DEPT SUPPLIES 102 4239011 1227069 -01 1,406.20 SPECIAL DEPT SUPPLIES I I I N'HSE DEA# Fed ID: 1 I- 3136595 e l I Mw his order as been processed by our. NORTHEAS D.C. 41 WEAVE ROAD DENVER, A 175 7 1 107 -0540 90 /BX PURPLE NITRILE PF GLOVE X -LARGE 20 20 C 8.25 165.00 2 ASE GOOD Z EM, MAY BE SHIPPED SEPARATELY. 2 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 20 20 C 8.25 165.00 4 ASE GOOD Z EM, MAY BE SHIPPED SEPARATELY. 3 463 -0952 EA SAM SPLINT ORNG 5.5X3/16" X -LARGE 25 B 0.00 0.00 I TEM BACK O ERED, WILL FOLLOW SHORTLY I 4 360 -1359 EA SAM SPLINT ORANGE /BLUE 36X4.25 25I 25 6.95 173.75 6 5 602 -8100 EA COLLAR EXTRIC. STIFFNECK ADJ. 50 50 C 5.90 295.00 5 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 6 667 -5231 10 /PK BITE STICK UNBREAKABLE N /TOXIC 3 3 3.05 9.15 6 7 119 -0470 EA EXTENSION SET SMALL BORE 1 1 0.00 0.00 7 NC HIS PRODucr IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIO1 CENTER. 8 555 -5396 PU EA PROTECTIV ACUVNC SFT CATH 20X1.25 50 50 2.50 125.00 7 HIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES DISTR'BUTIO1 CENTER. 9 555 -4687 PU EA PROTECTIV ACUVNC SFT CATH 22GX1" 50 50 2.70 135.00 6 BILL INVOI E TOMER P 1308571 ITEM STATUS KEY L �K EM KEY 12 2 7 0 6 9 01 MARK FUTemporarik ckordewd: Item will follow School Kit HIP NV I DATE F XE is;ontinucd: Item no longer available No Charge ecial Schein Free Goods 1308572 4/30/08 7 anufacwrcr will ship Item directly m you scription Drug: Return Authorization Required H I B R frigerated Item: May be shipped separately ecial Schein Pricing 114 5 2 2 0— 1 14 0 6 2 0 1 OF 3 unavailable: please reorder T Taxable Item Continued on Next Pa .-e WHSE DEA# Fed ID: 11-3136595 a, r. 10 555 -7390 U EA PROTECTIV ACUVNC SFT OATH 24GX5 /8 50 50 2.95 147.50 7 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. 11 555 -8102 PU EA PROTECTIV ACUVNC SFT CATH 16X1.25 50 50 2.70 135.00 7 HIS PRODUCc IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTIO1 CENTER. 12 499 -0526 EA WIRE LADDER SPLINT 12 12 4.65 55.80 6 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G POIN S, GIFTS OR O HER PECIAL AWA ZDS "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE 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 TIME, MED CARE, 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 RECORDS. IF YOU VE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS 3 URCHA E, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD I EXCES OF T OSE BENEFITS IVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS DISCOJNT AN SIMILARLY DI CLOSED. MERCHANDI E TOTAL 1406.20 INVOI E TOTAL 1406.20 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1406.20 V' BILL TO N I E TOMEP. P 1308571 ITEM STATUS KEY REM KEY 12 2 7 0 6 9 01 MARL{ 13 -Backordered: Item will follow LSK School Kit H INVOI TE pp g Discontinued: Item no longer available N No Char_e P Special Schein Free Goods 1308572 4/30/08 7 M- Manufacturer will ship Item directly to you P- prescription Drug: Return Authorization Rcyuired HSI NUMBER R Refrigerated Item: May he May separately Special Schein Pricing 1145220- 1 1406.20 2 OF 3 U- Temporarily unavailable: please reorder T Taxable Item Continued on Next Page WHSE DEA# Fed ID: 11- 3136595 s gg well q his order ias been processed by our NORTHEAS D.C. 41 WEAVEE ROAD DENVER, A 1751-7 1 644 -3135 5 /BX QUIKCLOT 25GM 1 1 38.25 38.25 1 2 221 -3973 3 /PK GLUCOBURST GLUCOSE GEL 15GM 12 10 5.25 52.50 1 ARTIAL SHIPMENT WILL SHIP AND INVOICE WHEN AVAILA LE. F YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER 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. 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 STICH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSq THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU RAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS URCHA E, THEN ANY B NEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD II EXCESS OF T OSE BENEFITS TIVEN OR NON -HS PURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED. MERCHANDI E TOTAL 90.75 INVOI E TOTAL 90.75 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 90.75 BILL TO INVOICE# T MER PO4 ITEM STATUS KEY REM KEY 1308571 1148573-01 MARK R nackordered: Item will follow SK School Kit D Discontinued: Item no longer available NC No Charge SHIP TO INV D _B I' Special Schein Free Goods M Manufacturer will ship Item directly to you 1308572 4/29/08 1 P- Prescription Drug: Return Authomation'Required R Refrigerated Item: May be shipped separately MEM BER HSI Special Schein Pricing U Temporarily unavailable: please reorder 1145220- 1 90.75 1 OF 2 T- Taxable Item Continued on Next Page Prescribed by State Board of Accounts City Form No. 201 (Rev. 1,995) 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)) 04/29/08 1148573 -01 EMS Supplies $90.75 04/30/08 1227069 -01 EMS Supplies $1,406.20 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 VGUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,496.95 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 1148573 01 102 390.11 $90.75 1 hereby certify that the attached invoice(s) or 1120 1227069 01 102 390.11 $1,406.20 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 d Title Cost distribution ledger classification if claim paid motor vehicle highway fund