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Home My WebLink About207087 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $481.14 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 207087 CHECK DATE: 3/13/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 3463917 -01 481.14 SPECIAL DEPT SUPPLIES MHENRY ScHEIN (1-9 SHIP TO /SOLD TO: EMS Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 INVOICE 540 W 136 St Station 46 Michael Kaufmann Carmel,IN 46032 -8806 0100001 30857103463917110010000000481 ,140221,127 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic .Sq BILL TO SHIP TO I INVOICE AMOUNT Carmel, IN 46032 -7543 1308571 1817102 481.14 INVOICP# INVOICE DATE 3463917 -01 2/21/12 CUSTOMER PO MARK please detach here and mail the above with your payment HSI. ORDER ORDER DATE' DUE DATE 98176875 02/21/12 03/22/12 WHSE DEA# RHO162494 Fed ID: 1 I- 3136595 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following address: ENRY SCHEI INC. EPT CH 102U ALATINE, I 60055 -0241 BII,L —INVO C INVOICE: AMOUNT ITEM STATUS KEY REM KEY 1308571 1817102 3463917-01 4 81.14 H Backordered. Item will follow SK School Kit D R ORDER: D DATE D Discontinued; Item no longer available NC No Charge HSI I' Special Schein Free Goods M Manufacturer will ship Item directly to you 98176875 02/21/12 2/21/12 7 P- Prescription Drug: Return Authorization Required R Refrigerated Item; Nlay be shipped separately CUS TOMER PO Special Schein pricing U 'remporarily unavailable; please reorder MARK 2 OF 2 T- Taxable Item H E NRY SCHEIN� ENDS O SA LE Payment Terms. We make event effor to maintain prices for the duration: of a payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, l owever, "Ne reserve the right to make price adjustments in VISA, MASTERCARD DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: If you have tried a pro duct and it is defective or does n perform (i 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. AlI invoices are choice. Simply tall our customer service departs ent w ithin 30 days of receipt of the rnerchan disc to arrange for the return. Fora payable within 30 days, warranty repair or if you were sent something you di =d 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 onily to registered, licensed healthcare professionals. If you are a new customer or have recently molted, please furr is h us with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate, verifying your shipping address. Class tl drugs can be ordered only by mail. International Orders: Please Note: We proudly serve healthcare professionals and governments Opened handpieces and equipment may not be returned for throu the world. e place orders or for ir'quires on export credit but will be repaired or replaced in accordance avith terms and conditions, please contact our Inrernatianal Depadment: manufacturer ,warranties. Before opening handpiece s or 1 800 84 3550 equipment, "'o si,=ggest tt at ymi check t he shipping container and packing list to verif 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 Prescrption Drugs. Sir ply call our Customer Service Department 1- 800 -845 -3550. r .a: Y..:. 1 ate. ��i. :�z a LP300 VOUCHER NO. WARRA N ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $481.14 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 I 3463917 -01 102 390.11 $481.14 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 MAR 12 2012 I Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 3463917 -01 $481.14 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