The URL can be used to link to this page

168025 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $2,322.40 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 168025 -r CHECK DATE: 1121/2009 DEPARTMENT ACCOUNT PO NUM IN VOICE N AMOUNT DESCRIPTION 102 4239011 3851379 -01 2,304.50 SPECIAL DEPT SUPPLIES 102 4239011 .6009591 -01 17.90 SPECIAL DEPT SUPPLIES WHSE DEA# Fed ID: 11- 3136595 a AA2. o r '.sue. ,a m�&ia o r w his order aas been processed by our NORTHEAS D.C. 41 WEAVER ROAD DENVER, 3 A 1751.7 17- 571 -266 RK 1 153-3144 20 /RL BIOHAZARD BAG 11X14.25RED 1GAL 10 10 1.79 17.90 1 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTRIBUTION CENTER. 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 ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOH DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE 11 0TICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, ZND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSI THE PURCHASES THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. IF YOU VE SED A HENR SCHEIN "HS CREDIT CARD TO MAK THIS DURCHASE, THEN ANY B NEFITS F ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IJ EXCESS OF T OSE BENEFITS TIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS k DISCOJNT ANI SIMILARLY DI CLOSED. MERCHANDISE TOTAL 17.90 INVOICE TOTAL 17.90 PLEASE PAY WITHIN THIRTY(3t) DAYS OF RE EIPT OF THIS INVOICE. 17.90 ITEM STATUS KEY REM KEY 1308571 6009591-01 MARK it Backordered: hem Hill follow SK School hit D Discontinued: Item no longer available NC -No Charge SHIP TO INVOICE DATE OF BOXES 1' Special Schein free Goods V1 Manufacturer will ship Item directly to you 1817102 1/06/09 1 P- Prescription Drug: Return Authorization Required R Refrigerated Item: May he shipped separately HSI NUM BER INVOICE TOTAL PAGE# Special Schein Pricing U Temporarily unavailable: please reorder 1145220— 3 17.90 1 OF 2 T 'raxableItem Continued on Next Page L WHSE DEA# Fed ID: 11-3136595 z In OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, jnND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT kGAINS1 THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RETAIN =SE RECORDS. IF YOU AVE SED A HENR SCHEIN "HS CREDIT CARD TO MAKE THIS URCHA E, THEN ANY BENEFITS ROM PURCHA ES OF HS PRODUCTS WITH THE CARD IN EXCES3 OF T OSE BENEFITS GIVEN OR NON -HS URCHASES MUST ALSO BE TREATED AS A DISCOJNT ANE SIMILARLY DISCLOSED. MERCHANDI E TOTAL 2304.50 INVOI E TOTAL 2304.50 PLEASE PAY WITHIN THIRTY(3 DAYS OF RECEIPT OF THIS NVOICE. 2304.50 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEIJ INC. EPT CH 10211 ALATINE, I 60055 -0241 BILL TO INVOICE# CUSTOMER PO# ITEM STATUS KEY REM KEY 1308571 3851379-01 MARK 13 -Backordered: Item will follow SK School Kit R D Discontinued: Item no longer available NC No Charge SHIP TO INVOICE DATE 4 OF P Special Schein Free (loads M Manulacmrer will ship Item directly to you 1817102 12/29/08 24 P I'rcscription Drug: Return Authorization Required HSI M BER INVOICE TOTAL PAGE# R Refrigerated Item: May he .chipped .auparately Special Schein Pricing 1145220— 3 2304.50 2 OF 2 T- Tamble Temporarily pleas Border L Payment Terms: We make every effonto maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN PLA TINUM Bt!.SINESS catalog, hovvever, we reserve the right to make price adjustments in CARD, VISA, MASTERCARD, DISCOVER and AMERICAN EXORESS response to rnanufactlurers price changes n pv Guaranteed Satisfaction: lf you have tried a product and it is defective or does not perform or salisfactorily, we will provide a credit, refund, of exchange; it:s your Bih Your Order To Your Or�eo Account choice. Simply call our customer service department within 30 days Available to licensed practitioners in the U,S All invoices are ofreceipt of the merchandise to arrange for the return. Fora payable within 30 days. warranty repair or it you were sent something you did rot order, simply call: Rx Products Controlled Substances. Matrx Medical 1-800-845-3550 Regu lationsrequire us to limit the sale mRxand controlled substances only to registered, licensed healthcare professionals. If you are a new customer or have recently moved, please furnish LIS with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA cortificate, verifying your shipping address. Class 11 drugs can be ordered only lb� mail, International Orders: PkeaawNote: We proudly healthcare undyovemmeu� Openedhaodp�caxande�uipmen\mayoo�berv�umedbr moghou(the vodd. To place o�emur for inquihps m� export urediibu��|\berepuirado/ep�unedioaoo�anoewiih \ht*nnoa»dnnndihono.p\easeoon|adoor|ntnmm\iono{Depa�men�� m8nufm�u�rwor�ndeo�Bebmnye»i»yhaodpiooeaor 1'800'845'3650 ea o ipment wp suggest that you check the shipping container and packing holtoverity that you have received exactly what Prescription [�K�� g��r�� i��W�t�0n�' �mn�pradO dCom tarSn�wuro|ano1returnab|o. Other restrictions may also apply. A Return Authorization in Required for all Prescription Drugs. Simply call our Customer Service Department 4-1-800-845-3550, n NIMRLXI� E1 \JRY SCHEIN `a`' SHIP TO: Carmel Fire Department MI INVOIC Station Kaufmann 135 Duryea Road, Melville, NY 11747 Carmel, IN 46032 -8806 0100001308571 03851379110010000002304501229080 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 BILL TO INVOICE TOTAL 1308571 2304.50 juvoicE# INVOICE DATE 3851379 -01 32/29/08 CIIS'POMER PO# SHIP 1'O MARK 181 7102 WHSE DEA# Fed ID: 11-3136595 g This order has been processed by our NORTHEAST D.C. 41 WEAVER ROAD DENVER, A 175 7 RK 1 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 100 100 C 8.36 836.00 11 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR EUTIO CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY 2 107 -0502 100 /BX PURPLE NITRILE PF GLOVE MEDIUM 100 100 C 8.36 836.00 21 HIS PRODUC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 890 -6868 3 /PK LIFEPAK 12 PAPER EKG 12 12 11.75 141.00 1 4 879 -8581 30 /PK MEDI -TRACE SNAP FOAM ELEC 530ECG 40 40 C 4.85 194.00 23 HIS PRODUCC IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIOE CENTER. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY 5 602 -8100 EA COLLAR EXTRIC. STTFFNECK ADS. 50 50 C 5.95 297.50 24 HIS PRODUcr IS BEING SHIPPED FROM OUR MIDWES DISTR BUTIO CENTER ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. F YOU ARE PARTICIPATING IN A DISCOUNT PROG (E.G. POINTS, GIFTS OR OTHER PECIAL AWARDS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPON DISCOUNT RECEIPT OR REDEMPTION, IOU ARE RECEI ING OR WILL R CEIVE BILL TO INVOICE# CUS TOMER P ITEM STATUS KEY REM KEY 1308571 3851379-01 MARK n nackordL'red: Item will lollo, SK School Kit $HIP 70 INVOICE E 1) Discontinued; Item no hmger aeailahlo NC -No Charge I'- Special Schain Prec Goo N M Manu]aelurcr will ship Item directly to you 1817102 12/29/08 24 P- Prescnption Drug: Return Authonration Required R Rclrigeratcd Lem: May 1 shipped sepawely PER INVOICE TOTAL PAGE Special Sehcin Pricing U Temporarily unavailahk, pleas, reorder 1145220- 3 2304.50 1 OF 2 j T- Ta.ahl,Lom Continued on Next Page.......... L 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)) 6009591 -01 EMS Supplies $17.90 3851379 -01 EMS Supplies $2,304.50 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. Henry Schein ALLOWED 20 IN SUM OF Dept Ch 10241 Palatine, IL 60055 $2,322.40 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 6009591 -01 102 390.11 $17.90 i hereby certify that the attached invoice(s), or 1 120 3851379 -01 102- 390.11 $2,304.50 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 ,IAN 1 7nflq a r Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund