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HomeMy WebLinkAbout170888 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 0 ONE CIVIC SQUARE HENRY SCHEIN INC `4 CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,214.42 PALATINE IL 60055 -0241 CHECK NUMBER: 170888 CHECK DATE: 4/16/2009 D EPARTMENT ACCOUNT PO NUMBE I NVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 2736649 -01 371.82 SPECIAL DEPT SUPPLIES 102 4239011 47699 -01 842.60 SPECIAL DEPT SUPPLIES :r P WHSE DEA# Fed ID: 11-3136595 y his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, A 175 7 1-317-428-8784 CELL (MARK) 1 891 -3037 PU 50 /CA IV PREP KIT W/ TEGADERM 6 6 C 61.97 371.82 6 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, 'IOU ARE RECEI1,ING OR WILL R1 OTICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, P.ND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT %GAINSq THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. IF YOU ZAVE SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS FROM PURCHA ES OF HS PRODUCTS WITH THE CARD III EXCES3 OF THOSE BENEFITS GIVEN OR NON -HS DURCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDISE TOTAL 371.82 INVOI E TOTAL 371.82 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 371.82 ILL TO INVOICEft E ITEM STATUS KEY REM KEY 1308571 2736649-01 MARK 13 Backordered: Item will follow SK School Kit D Discontinued: Item no longer available NC -No Charge HIP TO INVOICE DATE P- Special Schein I Goods M Manufacturer will ship Item directly to you 1817102 3/31/09 6 P prescription Drug: Return Authorization Required INVOICE TOTAL PAGE# R Refrigerated Item: May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder 371. 82 1 OF 2 T T :game Item Continued on Next Page L WHSE -DEA# Fed 1D: 11- 3136595 t y p �i�n 6 N y �f %,f Tn lZn 6 7! 1, x ��.z O his order ias been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, PA 175L7 t vIA RK 317-57.-2663 1' 878 -8721 EA ALCARE PLUS FOAM ALCOH OD 90Z 24 24 C 7.25 174.00 1 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 2 220 -1398 3 /ST BODY STRAP SET DISP YELLO W 30 30 4.89 146.70 4 3 602 -8100 EA COLLAR EXTRIC. STIFFNECK ADJ. 50 50 C 5.90 295.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 4 338 -2276 PU 100 /CA EXTENSION SET STD BORE UL 1 1 C 226.90 226.90 3 ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 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 SERVICES, RECEIVABLE OR REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM RULES. UPO4 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, PND UPON ANY S CH EQUEST, SUM VALUE MUST BE DISCLOSED AS A DI COUNT GAINSI THE PURCHASET THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THEESE RECORDS. IF YOU RAVE SED A HENRC SCHEIN "HS CREDIT CARD TO MAKs THIS DURCHASE, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IT EXCESS OF T OSE BENEFITS TIVEN OR NON -HS I DURCHASES MUST ALSO BE TREATED AS DISCO T AN SIMILARLY DI CLOSED. BILL TO INVOICE# CUSTOMER P ITEM STATUS KEY REM KEY 13 08571 47699 MARK B Backordered: hem will follow SK School Kit D Discontinued: Item no longer available NC -No Charge SHIP TO INVOICE DATE F BOXES F Special Schein Free Goods M Manufacturer will ship Item directly to you 1817102 4/03/09 4 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separatel}' INVOICE TOTAL PAGE# S Special Schein Pricing U Temporarily unavailable: please reorder 842.60 1 OF 2 T Taxable Item Continued on Next Page ENRY SC E SHIP TO: Carmel Fire Department MI INVOIC Stati Michael Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 010000130857100047699110010000000842600403091 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq BILL TO INVOICE TOTAL Carmel, IN 46032 -7543 1308571 842.60 INVOICE# INVOICE DATE 47699 -01 4/03/09 CUSTOMER PO# SHIP TO Ivyz�p u 1817102 Please detach here and mail the above with your payment WHSE DEA# Fed ID: 11- 3136595 R r,. 3 '8 s Y .G3 x �f RX MERCHANDISE TOTAL 842.60 INVOI E TOTAL 842.60 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 842.60 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: 'ENRY SCHEI INC. D EPT CH 10211 ALATINE, I 60055 -0241 SILL TO INVO CUS TOMER POM ITEM STATUS KEY REM KEY 1308571 47699 MARK 13 Backordered: Item will follow SK School Kit IP T INVOICE DATE F H XE D Discontinued: Item no longer available NC No Charge F- Special Schein Free Goods M Manufacturer will ship Item directly to vuu 1817102 4/03/09 4 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately P E Special Schein Pricing U Temporarily unavailable: please reorder 842.60 F 2 OF 2 T Taxable Item m HENRY CHEII` M a t rx M e di ca l M t E r"z S, 3 'da make every °far to maintain .ricps for he d €raiiaE; a° a Payment by CHECK or y the HENRY HEIN PLATINUM BUSINESS catalog, however, we reserve the right to make price adjustments in CARD, VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers price changes wau'glo Nai Guaranteed Satisfaction: or If you have tried a product and if is defective or does n ,t per`orM Beal V u, C d e r T o r 0 P .,a A c satisfamrily, we' w; l' provide a credit, refund, or exchange', it's- p choice. Simply y call cur customer service department within 3`v` days payable to licensed practltione:s in the U.u. All invoices are of receipt of the merchandise to arrange for the recur:,. For a pa' +'aNIG a i:hin 3u daV vrarranty repair or if you w ere serif sarnet` i you did not order, simply call; Rx Products Controlled Substances: Matrx Medical 800 845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered, licensed healthcare prafessiana`s. you are a new custarner or have recently moved, please furnish us `with a copy of your updated state registration. For controlled substances, furnish a coDv of Four DFA certit`icale, verifying your shipping address. Class dri:gs can be ordered only by mail. International Orders: �Ieas� �c�te: We p rcudiv serve healthcare professionals and governments Opened handpieces and equ may not be returned for throughout the wor To place orders or far inqu on exoor, oreuit b 1t be repaired or replaced in accoroance with terms and conditions, please con tact our international Departm manufacturer arranr.es. Before opening handp eves or 1 1 800 -84 -3150 equipment, ,R;'e suggest that you check the shippin container and packi list to verify that you i =av received e :!,,hat Prescription Drug Returns Instructions: you araered.Opened Corrm Computer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all Prescription Drugs. S;mu l al our C u stome r 8rvice Departmen tai 845- 3550. LP300 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)) 47699 -01 Misc. EMS Supplies $842.60 2736649 -01 Misc. EMS Supplies $371.82 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 $1,214.42 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 47699 -01 102 390.11 $842.60 1 hereby certify that the attached invoice(s), or 1120 2736649 -01 102 390.11 $371.82 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 APR Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund