HomeMy WebLinkAbout158921 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $198.00
CARMEL
ye, PALATINE IL 60055 -0241
CHECK NUMBER: 158921
CHECK DATE: 4/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 3981870 -01 198.00 SPECIAL DEPT SUPPLIES
i
ISE DEA# Fed ID: 11-3136595
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his`order las been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, PA 1751_7
1 499 -0769 PU EA IV START KIT 200 200 C 0.99 198.00 2
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POINTS, GIFTS OR OTHER
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, yOU ARE RECEI ING OR WILL RECEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO,TIIIE, 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 %GAINSI THE PURCHASE THAT
E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU IIAVE
U SED A HENRC SCHEIN "HS CREDIT CARD TO MAKE THIS PURCHASE, 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 k DISCOJNT ANE SIMILARLY DI CLOSED.
MERCHANDI E TOTAL 198.00
INVOI E TOTAL 198.00
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS INVOICE. 198.00
BILL
TO INVOICE INVOICE# CUSTO Poll
ITEM STATUS KEY REM KEY
--1-3 0 8 571 —3-9 818 7 -0 --0-1 MARK 13 Backordered:-Item will follow SK School Kit
HI T INVOICE DATE F BOXES D Discontinued: Item no longer available NC- No Charge
F- Special Schein Free Goods
M Manufacturer will ship Item directly to you
1308572 4/08/08 2 P- Prescription Drug: Return Authorization Required
R Refrigerated Item: May he shipped separately
H I HER INVOICE TOTAL PA E Special Schein Pricing
114S220- 1 198. 0 0 1 OF 2 T- Taxable Item unavailable: please reorder Continued on Next Pa
L
Prescribed by State Board of Accounts l; ry 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))
04/08/08 3981870 -01 EMS Supplies $198.00
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. WARRANT NO.
ALLOWED 20
Henry Schein
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$198.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
3981870 -01 102- 390.11 $198.00 1 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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund