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Home My WebLink About178712 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,373.18 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 178712 CHECK DATE: 10/28/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 3820068 -01 19.78 SPECIAL DEPT SUPPLIES 102 4239011 7036225 -01 680.00 SPECIAL DEPT SUPPLIES 102 4239011 7117868 -01 475.00 SPECIAL DEPT SUPPLIES 102 4239011 8605483 -01 198.40 SPECIAL DEPT SUPPLIES 1? HSE DEA# Fed ID: 11- 3136595 his order has been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, 3 A 175L7 ARK 1 499 -0516 EA ANKLE HITCH F/ TRACT SPLINT 2 2 9.89 19.78 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POINTS, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL R CEIVE OTI'CE OF TIE DISCOUNT VALUE. FROM TIME TO-TI.E, MEDICARE, MEDICAID; TRI ARE.OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, TND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSI THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDISE TOTAL 19.78 INVOI E TOTAL 19.78 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 19.78 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEI4 INC. DEPT CH 10211 ALATINE, I 60055 -0241 B ILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 3820068-01 MARK H liactiordcred: Item will follow SK School Kit D Discontinued: Item no longer available NC -No Charge S HIP TO INVOICE DATE OF BOXES 1' Special Schein free Goods M Manufacturer will ship Item directly to you 13 0 8 5 7 2 10/08/09 1 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately INVOICE TOTAL PAGE Special Schein Pricing U Temporarily unavailable: pleas: reorder 19.78 OF 1 T- Taxableltem Payment Terms: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes l S�F� Guaranteed Satisfaction: �wr A. If you have tried a product and it is defective or does not perform or satisfactorily, we will provide a credit, refund, or exchange; it's your Bill Your Order To Your Open Account Available to licensed practitioners in the U.S. All invoices are choice. Simply call our customer service department within 30 days payable within n days. of receipt of the merchandise to arrange for the return. For a 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 II drugs can be ordered only by mail. International Orders: Please N ote Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governments credit, but will be repaired or replaced in accordance with throughout the world. To place orders or for inquiries on export manufacturer warranties. Before opening handpieces or terms and conditions, please contact our International Department: equipment, we suggest that you check the shipping container 1-800-845-3550 800 845 3550 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. Y /HSE DEA# Fed ID: 11-3136595 II D a WE his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 175L7 RK 317-423-8784 1 933 -0986 10 /BG GOWN ISOLATION IMPERVIOUS YELLOW 32 32 6.20 198.40 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCH SE YOU HAVE EARNED A CREDIII TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE IOTICE OF `T 1E DISCOUNT VALUE. FROM TIME TO -TI.E, MEDICARE, MEDICAID, TRIT ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY S CH REQUEST, SUM VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSa THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. MERCHANDI E TOTAL 198.40 INVOI E TOTAL 198.40 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 198.40 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEIN INC. DEPT CH 10211 ALATINE, IL 60055 -0241 CUS BILL TO INVOICE41 ITEM STATUS KEY REM KEY 1308571 860S483-01 MARK B Backordered: Item will follow SK School Kit SH IP T INVOICE DATE F RE D Discontinued: Item no longer available NC- No Charge P Special Schein Tice Goods M Manufacturer will ship Item directly to you 1817102 10/OS/09 3 P Prescription Drug; Return Authorization Required R Refrigerated Item: May be shipped separately INVOICE TOTAL P Special Schein Pricing U Temporarily unavailable: please reorder 198.40 1 OF 1 T Taxable Item L Payment Terms: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers` price changes Guaranteed Satisfaction: vrsa If you have tried a product and it is defective or does not perform or satisfactorily, we will provide a credit, refund, or exchange; it's your Bill Your Order T Your Open Account choice. Simply call our customer service department within 30 your Available to licensed practitioners in the U.S. All invoices are of receipt of the merchandise to arrange for the return. For a 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 it drugs can be ordered only by mail. International Orders: Please No te: Opened handpieces and equipment may not be returned for We proudly serve healthcare professionals and governments credit, but will be repaired or replaced in accordance with throughout the world. To place orders or for inquiries on export manufacturer warranties. Before opening handpieces or terms and conditions, please contact our International Department: equipment, we suggest that you check the shipping container 1- 800- 845 -3550 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. d m n• Y mac.. A d W v gym• k WHSE DEA# Fed ID: 11- 3136595 x r r ��at d q 'L.. r his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, 3 A 175L7 1 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 100 100 C 4.75 475.00 5 HIS PRODUCr IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR O HER PECIAL AW S "DISCOUNT WITH THIS PURC SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N P-CCO DPSICE WITH DISCOUNT PROGRAM RULES. UFO? DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF THE 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 GAINS THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 475.00 INVOI E TOTAL 475.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 475.00 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEIN INC. D EPT CH 10211 ALATINE, I 60055 -0241 BILL TO NVOICE41 CUSTOMER PO4 ITEM STATUS KEY REM KEY 1308571 7117868-01 MARK 11 13ackordered: Item will follow SK School Kit D Discontinued: Item no loneer available NC -No Charee SHIP TO I NVOICE E P Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 10/15/09 5 p prescription Drug: Return Authorization Required R Refrigerated Item: May he shipped separately INVOICE TOTAL PAGE4 Special Schein pricing U Temporarily unavailable: please reorder 475.00 1 OF 1 T Taxable Item Payment Terms: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, however, we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: or If you have tried a product and it is defective or does not perorm Bill Your Order To Your Open Account satisfactorily, we will provide a credit, refund, or exchange; it's your Available to licensed practitioners in the U.S. All invoices are choice. Simply call our customer service department within 30 days payable within 30 days. j of receipt of the merchandise to arrange for the return. For a 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 DI=A certificate verifying your shipping address. Class 11 drugs can be ordered only by mail. International Orders: Plea Mote: We proudly serve healthcare professionals and governments Opened handpieces and equipment may not be returned for throughout the world. To place orders or for inquiries on export credit but will be repaired or replaced in accordance with terms and conditions, please contact our International Department: manufacturer warranties. Before opening handpieces or 1- 300 -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 cats our Customer Service Department @-800-845-3550, UK F3 D3 s•• :f, LP300 \dHSE DEA# Fed ID: 11-3136595 BETA his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 1751-7 1 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 20 20 C 8.50 170.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 60 60 C 8.50 510.00 8 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR 0 HER PECIAL AWA DS "DISCOUNT WITH THIS PURL 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 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, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINSI THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 680.00 INVOI E TOTAL 680.00 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 680.00 BILL INVOICE TOME e ITEM STATUS KEY REM KEY 1308571 7036225-01 MARK 13 nackordetcd: Item will follow SK School Kit Discontinued: Item no longer available NC No Charee S HIP TO INVOICE DATE OF BOXES F- Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 10/15/09 8 P Prescription Drug: Return Authorization Required R Refrigermed Item: May he shipped separately INVOICE TOTAL PArR# Special Schein Pricing U Temporarily unavailable: please reorder 680.00 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)) 7036225 -01 $680.00 7117868 -01 $475.00 8605483 -01 $198.40 3820068 -01 $19.78 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. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $1,373.18 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 7036225 -01 102- 390.11 $680.00 1 hereby certify that the attached invoice(s), or 1120 7117868 -01 102 390.11 $475.00 bill(s) is (are) true and correct and that the 1120 8605483 -01 102- 390.11 $198.40 materials or services itemized thereon for 1120 3820068 -01 102 390.11 $19.78 which charge is made were ordered and received except OF 2 6 2009 r Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund