HomeMy WebLinkAbout158436 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $5,532.21
PALATINE IL 60055 -0241
CHECK NUMBER: 158436
CHECK DATE: 4/15/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467006 2203008 -002 134.50 EMS EQUIP
102 4239011 2203008 -01 2,140.88 SPECIAL DEPT SUPPLIES
102 4467006 2203008 -01 269.00 EMS EQUIP
102 4239011 2203038 -01 431.25 SPECIAL DEPT SUPPLIES
;1 102 4239011 595477 -01 39.58 SPECIAL DEPT SUPPLIES
102 4239011 6601795 -01 1,000.00 SPECIAL DEPT SUPPLIES
102 4467006 9627024 -02 1,250.00 EMS EQUIP
102 4467006 9627913 -01 267.00 EMS EQUIP
WHSE DEA# Fed ID: 11- 3136595
+t n �a^3` -firms y '.uzvi F"i'`'bxi�,�� 9
g r c
,a c �e rz t /�s s
T his order as been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, DA 17517
1 420 -4674 EA NASAL ATOMIZATION DEVICE W /SYR 100 100 2.90 290.00 12
HIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES DISTREBUTIOIN CENTER.
2 420 -9994 EA NASAL ATOMIZATION DEVICE 100 100 2.45 245.00 12
HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTREBUTIO11 CENTER.
3 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 60 60 C 4.80 288.00 3
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
4 890 -6878 3I -LIFEPAK 12 PAPER EKG 20 20 _19.25 385.00- 10.
5 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 100 100 4.83 483.00 10
6 499 -0516 EA ANKLE HITCH F/ TRACT SPLINT 2 2 9.50 19.00 10
7 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 30 30 C 8.10 243.00 6
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
8 107 -0540 90 /BX PURPLE NITRILE PF GLOVE X -LARGE 10 10 C 8.10 81.00 7
ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY.
9 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 10 10 C 8.10 81.00 8
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
BILL To INVOIC CU STOMER INVOICE PQ# I ITEM STATUS KEY REM KEY
1308571 2203008 -01 REF142323032506 B- BackorderedtItem ill follow F NC K SchoolKit
D Discontinued: Item no longer available No Charge
HIP TO INVOICE DATE OF BOXES P Special Schein t=ree Goods
M Manufacturer will ship Item directly to you
1308572 3/25/08 12 P- Prescription Dtug: Return Authorization Required
R Refrigerated Item: May be shipped separately
HSI NUMBER INVOICE TOTAL PAGE# Special Schein Pricing
U Temporarily unavailable: please reorder
1145220- 1 2409.88 1 OF 3 T Taxable Item Continued on Next Page
WHSE DEA# Fed ID: 11-3136595
P
3,
o
T his order ias been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, DA 17517
1 180 -7538 EA LITTMANN CARDIOLOGY III BURGUM 1 1 134.50 134.50 1
F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE 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 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 S CH
EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSq THE PURCHASE THAT
E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU EAVE
SED A HENRC SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS
ROM PURCHASES OF HS PRODUCTS WITH THE CARD IN EXCES OF T OSE BENEFITS IVEN
OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED.
MERCHANDI E TOTAL 134.50
INVOI E TOTAL 134.50
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 134.50
BILL T INVO CU STOMER PQ# ITEM STATUS KEY REM KEY
1308571 2203008 -02 REF084516033108 n- Dackordered:Item ill follow SK SchoolKit
HIP T INVOICE DATE OF B XE D Discontinued: Item no longer available NC -No Charge
1' Special Schein free Goods
M Manufacturer will ship Item directly to you
13 0 8 5 7 2 3/31/08 1 P- Prescription Drug: Return Authorization Required
R Refrigerated Item: May he shipped separately
H I NTJM EER INVOICE TOTAL PA
Special Schein Pricing
U Temporarily unavailable: please reorder
1145220- 1 134.50 1 OF 2 T Taxable Item Continued on Next Page..........
L
WHSE DEA# Fed ID: 11- 3136595
P
WINE
his order aas been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, PA 1751-7
VIARK HULETT 317 -571 -2663
1 827 -2329 EA SUCTION UNIT W /DISP CANN 2 2 C 625.00 1250.00 2
ASE GOOD I EM, MAY BE SHIPPED SEPARATELY.
F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD
GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM
RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO T'I E, MED MEDICAID, TRI ARE OR
THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY STICH
EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSI THE PURCHASES THAT
EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU IIAVE
13SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS
FROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS TIVEN
OR NON -HS URCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DISCLOSED.
MERCHANDI E TOTAL 1250.00
INVOI E TOTAL 1250.00
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 1250.00
BILL TO INVOICE INVOICEff CUSTOMER PO# ITEM STATUS KEY REM KEY
1308571 9627024 -02 MARK HULETT 13- Backordered: Item will follow SK- SchoolKit
HIP TO INVOICE DATE F BOXES D Discontinued: Itcm no longer available NC No Charge
P Special Schein Free Goods
M Manutacmrer will ship Item directly to you
13 0 8 5 7 2 3/25/08 2 P- Prescription Drug: Return Authorization Required
R Retri Item: May be shipped separately
14 I NUMBER INVOICE TOTAL PA E
Special Schein Pricing
U Temporarily unavailable: please reorder
1145220- 1 1250.00 1 OF 2 T TaxabteItem
ConunuedonNextPage..........
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WHSE DEA# Fed ID: 11-3136595
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RK HULETT 317 -571 -2663
1. 499 -3262 EA ULTRA BREATHSAVER "D" BAG RED 1 1 267.00 267.00
P RODUCT IS 3EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTLRER.
F YOU ARE DARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER
S 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. UPOq DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL RECEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, 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 AGAINSU THE PURCHASE THAT
ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU 11AVE
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 114 EXCIES3 OF T OSE BENEFITS d
OR NON -HS DURCHASES MUST ALSO BE TREATED AS DISCOJNT ANE SIMILARLY DI CLOSED.
OUR ORDER 37010341 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL
E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS WHEN THEY ARE HIPPED
MERCHANDI E TOTAL 267.00
INVOI E TOTAL 267.00
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 267.00
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 INVOICE4 CUSTOMER PO# ITEM STATUS KEY REM KET
1308571 9627913-01 MARK HULETT 13 Backordered: Item will follow SK School Kit
D Discontinued: Item no longer available NC No Charge
S HIP TO INVOICE DATE OF 13 XES P- Special Schein Free Goods
M Manufacturer will ship Item directly to you
130 8 572 3/ 2 7/ 0 8 P- Prescription Drug: Return Authorization Required
R Refrigerated Item: May be shipped separately
x I B R Special Schein Pricing
U Temporarily unavailable: please reorder
1145220— 1 267.00 1 OF 1 T Taxable Item
N.n make ever- hx duration Pa ment by CHECK or by the HENRY SCHEIN PLA TINUM BUSINESS
cotalog. however, we reserve the hQk tomak pricmadjun'nienimin CARD, VISA, MASTERCARD, DISCOVER and
res tomanufactuem' price changes
Guaranteed Satisfaction:
or
Uynu have tried apmduct and i1iodo|aohvnur does not perform
naUsfomhiy.wo will provide anmdii. refund, orexohan ifa Available t licensed practitioners in the U,S. All invoice
ohoice. 8impI�` Call our customer service department wiffiin3Odays
payable wiihin 30 days
d reoniplof\hemerchandiae oarsmgeforthnnetum.Fora
w repair orit you waro sent something yuu did riot order,
uimp|ycaU�
Rx Products Controlled Substances:
Madrx Medical 1'800~845'3550
Roou|aduna require uo|o|imit the sale ofRxandonntm/ied
substances on|y|n registered, licensed heaNhca�epmfeos:une|s.
|�you a�anewou�nmoror have eoendymmmd.�emae�umioh
uawitha copy of your updated state egiotmdinn Foroontm||nd
substances, furnish aoopymfyourDEA'mrliUoato. verifying your
shipping address, C|assU drugs can benrdere donivbymail,
\n1ernationa!Orders:
Please Note:
Opened handpieces
end i t� adhx export throughout the word. Top�eo�e��hx inquines or,
umm'.uu repai mm
'crc�=�.o"ua"crr.,. terms and conditions, please contac our |ntremat
om"u'm.m'm w u"�x:�u� .eop"""y"mwp'"^="' l'8N}846'3��U
the shipping container
�m�umm0/xam��''�«^* �^ux/y�/u« Prescription Drug Returns Instructions:
you o�d dCom heSnMwareianotveturnub|e.
Other restrictions may also apply.
A Return Authorization in Required for a|| Prescription Drugs. Simply call
4 -80)0-8415-3550.
WHSE DEA# Fed ID: 1] -3136595
p"AM"W"
vIARK HUEITT 317-713-2663
1' 191-5917 100/BX FACESHIELD SYS FOR SANIBA 20 20 22.00 440.00
rHANK YOU JULIE BAKER 1-800-845-3550 X326
2* 499-0859 100/PK FACE SHIELD/LUNG-SANI-MAN 20 20 28.00 560.00
PRODUCT IS BEING SHIPPED TO YOU DIRECTLY FROM THE MA1TUFA= RER,
IF YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G., POINTS, GIFTS OR OTHER
SPECIAL AWAZDS ("DISCOUNT")), WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD
GOODS OR +VICES, RECEIVABLE OR REDEEMABLE :N ACCOZDANCE WITH DISCOUNT PROGRAM
RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, IOU ARE REC=,ING OR WILL RECEIVE
6TICE OF T E DISCOUNT VALUE. FROM TIME-TO TI E, MEDICARE, MEDICAID, TRI ARE OR
THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VkLUE, PND UPON ANY SIJCH
EQUEST, SU'H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINS I THE PURCHASE I THAT
ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN THESE RECORDS. IF YOU :IAVE
SED A HENR SCHEIN ("HS") CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY BNEFITS
FROM PURCHA3ES OF HS PRODUCTS WITH THE CARD Ill EXCES3 OF TFOSE BENEFITS GIVEN
FOR NON-HS PURCHASES MUST ALSO BE TREATED AS A DISCO )NT AN SIMILARLY DI CLOSED.
MERCHANDI;E TOTAL 1000.00
INVOI'E TOTAL 1000.00
PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS NVOICE. 1000.00
BILL TO INVOICE4 CUSTOMER Po M KEY
ITEM STATUS KEY REM KEY
1308571 6601795-01 MK-032708 11 Backordcrcd: Item will follow SK -,School Kit
Discontinued: Item no lon available NC No Charge
SHIP TO TNV()Tr7 T)LTP OF B FS �F Special Schein Free Goods
M Manufacturer will Ship Item directly to you
1 3 0 8-572 4/01/08 11 I Irescription Drug: Return Authorization Require
R Refri Item: May be shipped S
HER INVOICE TOTAL OF 2 T Ta
2AQE# Special Schein Pricing
U Tcmp ble jet please reorder
0 -e
114522 1 1000.00 1 j xa I tern Continued on Next Pa.
vnssueAw Fed ID: //-3/»^5y5
Co ntinue d Fhis order aas been processed by our NORTHEAS" D.C.
41 WEAVER ROAD
DENVER, 3 A 1751-7
14ARK 317-572663
F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAJI (E.G. POINrIS, GIFTS OR OTHER
PECIAL AWA DS ("DISCOUNT")), WITH THIS PURCR�SE YOU HAVE EARNED A CREDIr' TOWARD
GOOD S OR S RVICES, RECEIVABLE OR REDEEMABLE :N ACCOZDANCE WITH DISCOUNT PROGRAM
RULES. UPOi DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI OR WILL R=IVE
NOTICE OF TiE DISCOUNT VALUE. FROM TIME TO TIME, MEDECARE, MEDICAID, TRIEARE OR
OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VkLUE, PND UPON ANY STCH
REQUEST, SU VALUE MUST BE DISCLOSED AS A DICOUNT �.GAINSI THE PURCHASES THAT
EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE THESE RECORDS. IF YOU EAVE
JSED A HENR( SCHEIN CREDIT CARD TO MAK THIS DURCHASE, THEN ANY BENEFITS
FROM PURCHA3ES OF HS PRODUCTS WITH THE CARD 14 EXCES3 OF THOSE BENEFITS TIVEN
FOR NON-HS DURCHASES MUST ALSO BE TREATED AS k DISCOUNT ANI SIMILARLY DIECLOSED.
YOUR ORDER 58022917 HAS BEEN SPLIT INTO MULTI)LE SHIDMENTS. CERTAIN ITEMS WILL
BE SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ETEMS WHEN THEY ARE SHIPPED
MERCHANDISE TOTAL 39.58
INVOI('E TOTAL 39.58
PLEASE PAY WITHIN THIRTY(3 ll DAYS OF RE Ci EIPT OF THIS INVOICE. 39.58
BILL TO INVOICE# CUSTOMER P09 ITEM STATUS KEY r KE�Y
1308571 59S4777-01 MARK 13 Backordered: Item will follow SK School Kit
Discontinued: Item no longer available NC N(
SHIP TO INVOICE DATE 4 OF BOXES i Special Schein Free Goods
HSI N1 INVOICE TOTAL PAGE4 Speci-I Schein pricing'
N ext P age
WHSE DEA# Fed ID: 11- 3136595
v
ff
21
!J 9
4 1 all M.- PIN& a,
im
1 499-1835 EA TOGGLE W/ROLL PIN 75 75 5.75 431.25
IF YOU ARE DARTICIPATING IN A DISCOUNT PROGRAJI (E.G., POINqS, GIFTS OR OTHER
SPECIAL AWAZDS ("DISCOUNT")), WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD
GOODS OR SRVICES, RECEIVABLE OR REDEEMABLE _N ACCOZDANCE WITH DISCOUNT PROGRAM
RULES. UPOq DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEI%ING OR WILL RECEIVE
OTICE OF T DISCOUNT VALUE. FROM TIME TO TI E, MED[CARE, MEDICAID, TRICARE OR
DTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, jnND UPON ANY STCH
:ZEQUEST, SU VALUE MUST BE DISCLOSED AS A DISCOUNT AGAINS I THE PURCHASES THAT
EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE THESE RECORDS. IF YOU IIAVE
SED A HENR SCHEIN "HS") CREDIT CARD TO MAK THIS URCHASE, THEN ANY BENEFITS
ROM PURCHA3ES OF HS PRODUCTS WITH THE CARD I EXCESS OF THOSE BENEFITS IVEN
OR NON-HS ?URCHASES MUST ALSO BE TREATED AS DISCO AN E SIMILARLY DI CLOSED.
IYOUR ORDER 57346138 HAS BEEN SPLIT INTO MULTI LE SHI:)MENTS. CERTAIN ITEM WILL
BE SHIPPED SEPARATELY. YOU WILL BE BILLED FOR THESE [TEMS WHEN THEY ARE HIPPED
MERCHANDI E TOTAL 431.25
INVOI E TOTAL 431.25
PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS NVOICE. 431.25
PLEASE NOTE NEW REMIT TO ADDRESS
Please remi payments only to the following aldress:
4ENRY SCHEI INC.
DEPT CH 102 1
PALATINE, 1 60055-0241
13ILL TO INVOI 4 CUSTOMER PO# ITEM STATUS KEY REM KEY
1308571 2203038-01 REF142411032508 13 Ilackordered: Item ill follow SK School Kit
1) Discontinued: Item no lonLcr available NC No Charge
SHIP T INVOICE DATE OF BOXES F Special Schein Free Good,
M Manufacturet will ship Item directly to you
13085 72 4/02/08 11 Prescription Drug: Return Authorization Required
R 2 Item: Mal be shipped separately
NUMBER INVOICE TOTAL PACE# Special Schein Pricing
U Temporan1v unavailable: please reorder
114S220- 1 431.25 1 OF 1 T Taxable hc�n
Ne make everu0odtoma�ain dur-��,tionoia i Payment by CHECK or by the HENR Y SCHEIN PLA TINU&I SUSINESS
cm��g.howav �we�oemoUe ��ee�uo�non�in EXPRESS
eoponaetomunufactue�'pnoech�ngoo
Guaranteed Satisfaction:
or
K have |hedapmduc' and i detective or does nolpednnn
oaiisiacturi|y.v�ewi||pmvideanredii.r�und.orexuhongoj[eyour
oho�e. @mp� call ourcu�umoraemimedepaMm�n�within30duya
o*eceiptof the merchandisetnmrrangeinr 'he reNm. Fora
arrafflv re rurdyouwaeeon�som�hingyou did' nolorder,
—'r'—': Rx Products &Control|ed Substances:
Matrx Medical 1~800-840
Re�u�done reouir us to|imhtheoa!eofRxamdoo�ndied
oubnmcem only 1omgistmred. |imanedhm��hoarepmfesuionoin.
|�you area naw customer or have eoonUymovod. Please fuminh
Lis wThennpynfyour updated state reds�rat}nn. Forcnnlm||nd
substances, lumiohaonpyofyourDEAce�Nixa1o. vorifyingyuur
ahippingaddremo, 1 |ass||drugncanbon�eredon\ybymaii.
International Orders:
Please N ote:
Mei -1.udiv serve h eKhcarepmfnsniona/aondgovammaMn
Opened handpie,uea and equipment may no' be'e\urnedfor 1h To s
buiwi0beepai�dnroep|eoedinaccordancewi�h
�mmandonnd�one.��meom�ct our |n�mabon�Depu�ment�
manu|ac!umr�ar�ntiea,Befo�np*»inghandpienea:r 1'8O 5O
equipmyn�,wenuggostthatyouchaokthe shboing container
andpackir g!ist tovarifv that yuu have reoeivedexact|ywhat Prescription ��yU� Returns Instructions:
�morde�d,OpenedCum herSo#wareianotreturoab/e.
Other restrictions may also apply,
A Return AuthnhzahonioRequired for all PreachpdvnDmga.Simp|ycoU
ourCu�umerSamiueDepa�nen��1f0O�45'356O�
WHSE DEA# Fed ID: 11-3136595
T
ME
RE
B ffiix�
ONE
10 988-1028 EA INTUBATION KIT RED 1 1 25.88 25.88 12
HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES" DISTREBUTIO CENTER.
11 180-7538 EA LITTMANN CARDIOLOGY III BURGUM 3 2 134.50 269.00 10
PARTIAL SHIPMENT WILL SHIP AND INVOICE WHEN AVAILA3LE.
12 499-0814 24/CA INSTANT WINTER COLD PK OD 1 1 C 0.00 0.00 9 NC
ASE GOOD ICEM, MAY BE SHIPPED SEPARATELY.
F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAI (E.G., POINIS, GIFTS OR O'HER
P PECIAL AWA S ("DISCOUNT")), WITH THIS PURL SE YOU HAVE EARNED A CREDI TOWARD
GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE _N ACCOZDANCE WITH DISCOUNT PROGRAM
RU LES.
ULES. UPO DISCOUNT RECEIPT OR REDEMPTION,, OU ARE RECEI%ING OR WILL R:CEIVE
OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRITARE OR
DTHER PAYER MAY REQUEST INFOR111 REGAARDINC SUCH VALUE, PND UPON ANY STCH
:ZEQUEST, SU_'H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINS l THE PURCHASES THAT
EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE' THESE RECORDS. IF YOU IIAVE
JSED A HENRe SCHEIN ("HS") CREDIT CARD TO MAKE THIS PURCHASE, THEN ANY BENEFITS
ROM PURCHASES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF THOSE BENEFITS IVEN
OR NON-HS PURCHASES MUST ALSO BE TREATED AS A DISCO AN E SIMILARLY DI CLOSED.
OUR ORDER 57346138 HAS BEEN SPLIT INTO MULTIPLE SHIPMENTS. CERTAIN ITEM WILL
E SHIPPED 3EPAPATELY. YOU WILL BE BILLED FOR THESE ITEMS WHEN THEY ARE HIPPED
MERCHANDI E TOTAL 2409.88
INVOITE TOTAL 2409.88
PLEASE PAY WITHIN THIRTY(3)) DAYS OF RECEIPT OF THIS _NVOICE. 2409.88
BILL TO INVOICE CUSTOMER PO# ITEM STATUS KEY REM A
1308571 2203008-01 REF142323032508 13 -Backordened: hem vill follow SK School Kit
Discontinued: item no longer available NC No Charge
SHIP TO INVOICE DATE OF BOXES iF Special Schein Free Goods
N4 Manufacturer will ship Item directly to you
13085 72 3/25/08 12 11 Prescription Drug: Return Authon"ation
EF R
]Uri2crated Item: May he shipped separately
nTAL
NUM INVOICE T PAGE# S Special Schein pricing
U Temporarily unavailable: please morder
1145220- 1 2409.88 2 OF 31 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))
03/25/08 2203008 -01 EMS Supplies $2,140.88
03/25/08 9627024 -02 Sunction Unit $1,250.00
03/25/08 2203008 -001 Stethoscopes $269.00
03/27/08 9627913 -01 EMS Bags $267.00
03/31/08 2203008 -002 Stethoscope $134.50
04/01/08 6601795 -01 EMS Supplies $1,000.00
04/02/08 2203038 -01 EMS Supplies $431.25
04/02/08 595477 -01 EMS Supplies $39.58
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
$5,532.21
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# /Dept. INV ICE NO. ACCT #/TITLE AMOUNT Board Members
ca 22 008 -01 102- 390.11 $2,140.88 1 hereby certify that the attached invoice(s), or
f
627024-02 102- 670.06 $1,250.00 bill(s) is (are) true and correct and that the
j 203008 -001 102 670.06 $269.00
materials or services itemized thereon for
9627913 -01 102 670.06 $267.00
r 2203008 -002 r02- 670.06 $134.50 which charge is made were ordered and
✓6601795-01 02- 390.11 $1,000.00 received except
2203038 -0 1'02- 390.11 $431.25
o 595477 -01 102- 390.11 $39.58
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund