HomeMy WebLinkAbout179239 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1
ONE CIVIC SQUARE HENRY SCHEIN INC
CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $152.50
PALATINE IL 60055 -0241
CHECK NUMBER: 179239
CHECK DATE: 11/11/2009
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 8446223 -01 152.50 SPECIAL DEPT SUPPLIES
WHSE OEA# Fed ID: 11- 3136595
A. rom
,.xIId 7 1
his order aas been processed by our NORTHEAS D.C.
41 WEAVER ROAD
DENVER, A 1751.7
1 499 -5894 EA HOSE BARB FITTING 25 25 6.10 152.50 1
F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER
PECIAL AWA DS "DISCOUNT WITH THIS PURC SE 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 RECEZ ING OR WILL R CEIVE
TOTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRIi,ARE OR
THER PAYER MAY REQUEST INFORMATION REGARDING SUCH LUE, P ?D UPON ANY S ITCH
R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSI THE PURCHASEI THAT
E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS.
MERCHANDI E TOTAL 152.50
INVOI E TOTAL 152.50
PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 152.50
LEASE NOTE NEW REMIT TO ADDRESS
P lease remi payments only to the following a dress:
H ENRY SCHEIi INC.
EPT CH !0211
ALATINE, I 60055 -0241'
BILL TO INVOICE# T MER PO# ITEM STATUS KEY REM KEY
1308571 8446223-01 MARK 13 13ackordered: Item will follow SK School Kit
D Discontinued: Item no longer available NC No Charge
HIP TO INVOICE DATE OF BOXES P Special Schein hree Goods
M Manufacturer will ship Item directly to you
1308572 10/22/09 1 F- Prescription Drug: Return Authorization Required
R Refrigerated Item: May be shipped separately
INVOICE TOTAL PAGE# Special Schein Pricing
U Temporarily unavailable: please reorder
152.50 1 OF 1 T Taxable Item
VIVe make ever effor to rnalntain Prices for the dmaflonofa
Payment by CHECK or by the HENRY SCHEIN CREDIT CARD.
ua��g.howev �wemseme�ehgk to make n�mm�ua�mn�in VISA, MASTERCARD. DISCOVER and AMERICAN EXPR,
reuponaotomanufactue,rs'phcechanges
Guaranteed Satisfaction:
or
|`ynu have tried a product and i dons not perform
till f' nder To Yc,�Jr Open A
saha(actod|y.vv all pmvidoanredi\ refund.ur hon it's your
ohu�e� £imp�xa||uurouo�0eraem��de �monte�in3Gdayo
Avail, a to licensed practiti-, -e in the US, All invoices are
pavk within 3n days.
ofrnoeip1nf the merchandise arrange {orthnreturn, Fora
warranty repair Vrit youwere sent oomethingyuudid not o�or.
oinplycu||�
Rx Products Controlled Substances:
Matrx Medical 1-80O-845~3550
�egu|��ons i �|imit�heo�!e�Rxandonnnd|od
oub�omoeuon!y1oeg�e�d.|inenuedhea|��mmpm�oxuna|a�
|iVou are anew customer or have econ8y moved, please |umioh
uowiithe For controlled
nub�unceo.�umishaonpynyyourDEAoehiiica-o
shipping addiess.C|assUdmga car, beomeedun|ybymail.
International Orders:
VV pm d| eh a|t�mepn��sionaluandOovemmen's
Opened hand i and' equ\pmen1 may not b* returned fnr 1h'u0�u�ih To place orders ur(urinquirieannaxpoM
oen*;�bu|ei||heepairedor replaced inauc:rlanoewiLh �enno"�dordihun�. please con(actour/n�m�bn�Dep6Wn�nt:
d Be DD
i h
o^um'u^m'upmv� �vp�o� m 1�O0�46�SEQ
equipment, we sugaest that vou check the 3hipping container
and pacmng list m verify Prescription Drug Returns Instructions:
Other you ornered.0pened Computer Software is not returnable.
also apply. A Return Authorization is Required for Prescription Drugs, Simplyuy|
ourOue�merSem�eDaya�me��1�S0�45�55O.
Prescribed by State Board of Accounts City Fo No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
a
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))
8446223 -01 $152.50
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
VOUCHFR N-0. WA RRANT NO.
ALLOWED 20
Henry Sf-iein
IN SUM OF
Dept Ch 10241
Palatine, IL 60055
$152.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 8446223 -01 102 390.11 $152.50 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
NOV
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund