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
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WHSE -DEA# Fed 1D: 11- 3136595
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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
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'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