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Home My WebLink About208318 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $3,944.64 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055 -0241 CHECK NUMBER: 208318 CHECK DATE: 4125/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 1407289 -01 1,069.34 SPECIAL DEPT SUPPLIES 102 4239011 7150538 -01 46.30 SPECIAL DEPT SUPPLIES 102 4239011 9782287 -01 2,829.00 SPECIAL DEPT SUPPLIES HSI ORDER ORDER DATE DUE DATE 99151783 03/27/12 04 2 6 1 2 WHSF DEA# 8140162494 Fed 11): 11-3136595 his order as been processed by our MIDWEST D.C. 5315 WES" 74TH 3TREET INDTANAPOLTS,TN 46268 VIARK 317-423-8784 317-571-266 1 107-0501 100/BX PURPLE NITRILE PF GLOVE SMALL 10 10 C 8.45 84.50 1 C ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 2 107 100/BX PURPLE NITRILE PF GLOVE MEDIUM 20 20 C 8.45 169.00 3 CASE GOOD IPEM, MAY BE SHIPPED SEPARATELY. 3 107 0530 30 100/8X PURPLE NITRILE PF GLOVE LARGE 60 60 C 8.45 507.00 9 GOOD I'EM, MAY BE SHIPPED SEPARATELY. 4 107 90/BX PURPLE NITRILE PF GLOVE X-LARGE 20 20 C 8.45 169.00 11 CASE GOOD TCEM, MAY BE SHIPPED SEPARATELY. 5 111 100/CA RAZOR STERILE SHAVE PREP 2 SIDED 2 2 C 30.50 61.00 13 CASE GOOD irEm, MAY BE SHIPPED SEPARATELY. 6 602-8100 EA COLLAR STIFNECK SELECT ADULT 100 100 C 5.95 595.00 15 CASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 7 935 50/PK BLUE SENSOR SP ELECTRODES 80 80 11.55 924.00 16 8 890 3/PK LIFEPAK 12 PAPER EKG 18 18 10.87 195.66 17 BILL TO SHIP TO INVOICE INVOICE AMOUNT I rnm S KEY C 1308571 1817102 9782287-01 2829.00 11 Backordered: 11cm will tollow SK School Kit H ORDER ORDER DATE INVOICE DATE OF BOXES 1) Discontinued: 11cm no longer available NC- No Charge 4 F Special Schein Fn, Goods N1 ManuJacturer will ship hem directly to you 99151783 03/27/12 3/27/12 17 P Prescription Ding: Return Authorization Requited CUSTOMER PO4 PAGE# R Re1mcrated hem: May be shipped separately Special Schein Pricing U Tempomnly unavailable: please reorder MARK 1 OF 2 T -Taxable bent Continued mi Next Page ENTRY CE} EMS SHIP TO /SOLD TO: I V Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 540 W 136 St Station 46 Michael Kaufmann Carmel, IN 46032 -8806 01 00001308571097822871 ,10010000002829000327],28 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic S q BILL TO I SHIP TO INVOICE AMOUNT Carmel, IN 46032 -7543 1308571 1817102 2829.00 INVOICE# INVOICE DATE 9782287 -01 3/27/12 CUSTOMER PO l MARK please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 99151783 03/27/12 04/26/12 WHSE DEA# RH0162494 Fed ID: 11- 3136595 Nam F o AN r 9 101 -5979 6 /BX CLOTH SURGICAL TAPE 2 "X10YD 16 16 7.74 123.84 17 F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCHASE YOU HAVE EARNED A CREDIr I TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, 'IOU 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 V LUE, PND UPON ANY S CH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSI THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 2829.00 Invoice Date 30 days 2829.00 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102 1 ALATINE, I 60055 -0241 BILL TO SHIP TO INVOICEft INVOICE AMOUNT ITEM STATUS KEY RENT KEY 1308571 1817102 9782287-01 2 8 2 9. 0 0 B Backordered: Item will follow SK School Kit D Discontinued: Item no longer available NC -No Charge H I ORDER ORDER DATE INVOICE DATE F BORE P- Special Schein free Goods 99151783 03/27/12 3/27/12 17 11 Ma will n e ut do y ou I' Pitscription Drug: Return Authari nation Itcyuircd R Refrigerated Item: May be shipped separately CUS TOMER PO# PA E Special Schein Pricing U -Temporarily unavailable: please reorder MARK 2 OF 2 'r Taxable hen, 9i HENRY SCHEIN"" EMS SALE We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, ho.. we reserve the right to make price adjustments in VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to rnanufacturers' price changes vzsa Guaranteed Satisfaction: W If you have tried a product and it is defective or does not perform# «rgr Yrrrr Oar curt satis #actcrily, }e will provide a credit, refund, or exchange; it's your Available to licensed practitioners in the US. All invoices are choice. Simply call our customer service department within 30 days payable within 30 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 ne a storner or have recently moved, please furnish Lis with a copy of your updated state registration. For controlled substances, furnish a copy of your DEA certificate verifying your shipping address. Class 11 drugs can be ordered only by mail. International Orders: Please Note: Opened handpieces an equipment may not be returned for We proudly serve healthcare professionals and governments throughout the world. To place orders or for inquiries on export credit, but will be repaired or replaced in accordance with manufactt rer tvarranfies. Before opening handp eves or terms and conditions, please contact our International Department: 1-800 815 3350 equipment, :.le suggest that you check the shipping container and packing list to verify that you have received exactly ,:hat Prescription Drug Returns Instructions: you order ed.Opened tomputer Software is not returnable. Other restrictions may also apply. A Return Authorization is Required for all Prescription Drugs. Simply call our Custorrter Service @1-800-845 GOMME LP300 HSl ORDER# ORDER DATE LE DUE DATE 99343670 04/04/12 0 WHSEDEA# RHO162494 Fed ID: 11-3136595 I R ININ ON -A his order has been processed by our MIDWEST D.C. 5315 WES" 74TH STREET INDIANAPOLIS,IN 46268 1 666 EA SHARP DISP.CONTAINER RED 18GA/EA 2 2 23.15 46.30 1 F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINIS, GIFTS OR or HER PECIAL AWA DS ("DISCOUNT")), WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR SPRVICES, RECEIVABLE OR REDEEMABLE :N ACCOZDANCE WITH DISCOUNT PROGRAM RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, ARE RECEI ING OR WILL R CEIVE OTICH OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR OTHER" PAYER MAY REQUEST 'INFORMATION REGARDING SUCH V LUE, PND UPON ANY SIJCH REQUEST, SU VALUE MUST BE DISCLOSED AS A DI COUNT AGAINS I THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH ESE RECORDS. MERCHANDI E TOTAL 46.30 Invoice Date 30 days 46.30 PLEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following aidress: HENRY SCHEI4 INC. DEPT CH 10211 PALATINE, 1, 60055-0241 B ILL TO SHIP TO "•INVOICE I I W 0 ICE M 0 UN T ITEM STATUS KEY REM KEY 1308571 1817102 7150538-01 46.30 B liackordered: Item will follow SK School Kit HSI ORDER# ORDER DATE INVOIC E D A T E OF F30XES 1) Discontinued: Item no longer available NC No Charge F- Special Schein free Goods M Manufacturer will ship Item directly to you 99343670 04/04/12 4/04/12 1 11 Prescription Drug: Return Authorization Required CUSTOMER PO4 PAGE R Refrigerated Item: May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder �P30PRK 1 OF 1 T Taxable hem L die make every rffo `'c naintai prices for the duration of a Payment by CHECK or by the HENRY SCI EIN CREDIT CARD, rata: g, 1'o,Fie'ver, t:1 reserve th right to (Hake price adjust: E nts VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers' price changes Guaranteed Satisfaction: or If .ou have tried a crcduc and it is defective or does not cerfo Bill Yo Order o Your Open r o rat satistac °drily, we will urov:de a credit, refund, or exchange: it's your vtai :ab.o to Ilc nsud raE.tit or:ers .r: t :E? U.� i choice. Simply call our customer service de;aarImeN 4 hin '30 days p° es are 0': r 'i:ciut f the rT1B(4':ar':diSu' t o arrange for the re 'urn. For r a pay' with in �ii <zJ'S. .;arrant- ;evair or it yon ;ere sera something you did not order, s; ail: x Products Controlled Substances: Matrx Medical 1 -800- 845-3550 Regulatio:'S rectuir:: us to limit the sale of 'fix and controlled substances o r` to .registered, l ceased healthcare professionals. If you are anew customer or have recently moved, please furs ish us odth a copy of your updated state r0stragon. For controlled substances, L,rnish a copy of your DEA certificate, verifying yo: r shipping address, Class It drugs can be ordered only by °.rail. International Orders: Pleasc- Note: Opened hand ;eces and e' moment ,a„ not to returned for vie proudly servo health :Care professionals and governments k p E v throughout the world, o p ace orders cr for iF-g r es on export credit tut wpYill be repaired or r f;laced in acccrdancE .i ifh terms an d conditions please contact our Inter��aJonal Department: manufactu ?e r y ^.arranges.130ore opening ha dp eces or 1-800-845-355`0 equipment, we suggest that you check the shippi con fainer and packing list to verify that you have received exactly: what Prescription Drug Returns lrtstructions. you ordered.Opened Computer Software is not returnable. Other restrictions may also apply. A iFlefurn Authorization is Required for all Prescription Drugs, Sin ply call our 4ustomer Service Department 1- 800-845)-3550. i�'a_"�;. ?�,„.°et gz aa''` fi ��,'�s"� ::i� k �>E x?,� 'a Y.. t,€ �:fi t' x I LZ== 05 1 �O3 11 WHSE DEA# RHO162494 Fed ID: 11-3136595 000 w" T This order as been processed by our MIDWEST D.C. 5315 WES" 74TH STREET INDIANAP LIS,IN 46268 IARK828-428-8784 1 555-5396 U EA PROTECTIV ACUVNC SFT OATH 20X1.25 150 150 2.73 409.50 11 2 555-1166 [U EA PROTECTIV ACUVNC SFT CATH 18X1.25 100 100 2.73 273.00 11 3 891-3037 U 50/CA IV PREP KIT W1 TEGADERM 4 4 C 62.19 248.76 4 ASE GOOD I MAY BE SHIPPED SEPARATELY. 4 153-.6483 250ML/BT STERILE WATER FOR IRRIG 250ML 48 48 C 1.15 55.20 N PEDIGREE ITEM. 2ASE GOOD IPEM, MAY BE SHIPPED SEPARATELY. '4DC:0033800)402 5 496-6428 100/BX LANCET SURGILANCE GRAY 23G 1.8 3 3 10.96 32.88 11 6 499-0814 24/CA INSTANT WINTER COLD PK OD 4 4 C 7.25 29.00 10 GOOD ITEM, MAY BE SHIPPED SEPARATELY. 7 221-3973 3/PK GLUCOBURST GLUCOSE GEL 15GM 4 4 5.25 21.00 11 S OR 0 HER IF YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFT SPECIAL AWA DS ("DISCOUNT")), WITH THIS PUR SE YOU HAVE RNED A CREDI TOWARD IN S' GIFTS F F ARE ARTI PA E RN ED D I YOU C I TI' PO 3 PECIAL AWA DS "DISCOUNT ISCOI V GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE ACCO LD7ANCE WITH DISCOUNT PROGRAM SHIP To 70�16 1 0 ITEM STATUS KEY FTREF-M 308571 71 181 02 1407 1 289-01 1069.34 11 Backordered: Item will follow SK School Kit H qRDER ORDE AT T E DATE 4 OF BOXES 1) Discontinued: hem no longer available NC No Char I' Special Schein Free Goods 3 9 3 0 5 14 0 04 4/03/12 11 M Manufaconer w-ill ship Item directl to you 11 prescription Dru Return Authorization Required CUSTOMER PO PA R Reffterau,d Item: May be shipped separately Special Schein pricin U Temporarily unavailable: please reorder MARK 1 OF 2 T Taxable Itcm Continued on Next Page 3300 HENRY SCH EIN@ EMS SHIP TO /SOLD TO: I Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 540 W 136 St Station 46 Michael Kaufmann Carmel, IN 46032 -8806 0100001308571014072891 10010000001069340403120 BILL To: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept MI 2 Civic .SCI BILL TO I SHIP TO I INVOICE AMOUNT Carmel, IN 46032 -7543 1308571 1817102 1069.34 INVOICE# INVOICE DATE 1407289 -01 4/03/12 CUSTOMER PO MARK Please detach here and mail the above with your payment HSI`ORDER ..ORDER DATE: "DUE DATE`: 99305140 04/03/12 05/03/12 WHSE DEA# RHO] 62494 Fed ID: 11- 3136595 e b�.; itl RULES. UPO4 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MED CARE, MEDICAID, TRI ARE OR O THER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, PND UPON ANY STICH R 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. N HENRY 3CHEIN, INC. HAS PURCHASED THE SPE IFIC U4IT OF THE PRESCRIPTION DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 1069.34 nvoice Date 30 days 1069.34 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHE14 INC. EPT CH 10211 ALATINE, I 60055 -0241 SILL TO SHIP TO '`INVOICE 'INVOICE 'AMOUNT ITEM STATUS KEY REM KEY 08571 181710 2 1407289-01 1069.34 li Backordered; Item will follow SK School Kit I OR DER ORDER' DATE INVOICE DATE OF ES D Discontinued; Item no longer available NC- No Charge Special Schein free Goods Drug'. bt Item drectly ocd` 1 1� 1'n.xrip \ion Dcng'. Retum no\hornauon Rcyuimd R RC(tigoc'a\cd 1 \cm'. Nlay he shipped scpaca�c \y JeAGE .'rly $-Specia \Schein \ridng c Taxable rein C�S�OM�R 40 2oF2 MARK N H ENRY SCREW P AL A-1111'ARI EMS ERMS OF 1 4n, make c ever o`t n <flnf<;i Payment by r ri:;es for the durafior; of a CHECK car y the HENRY SC`HEI CREDIT CARD cataioa, I o ,e e Vr,e reserU -e 0:0 rich' to make oriceadjustmen VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacturers` price 10anges G uaranteed Satisfactions or If ,vou have tried a product and it is defecfire or does not not oerfor f 1 ":)uf Ondfer To Your €r ,r, k,-our;". satisfactorily, r;8'vl`ili provide a credit, refund, or exchange; it syo it n n U. ti choice. Simply call o it customer serv ice departrr,ent .Ar thi '30 stays Arai �fb to lic c� prat;fit i r r f ll;' Svc ic{ a ar of r ipf of the rner4'%a:A:se'o arrange for the return. Fora Payab within days, .;arrarrty repair or if yo :i,-ere Sent something yo u did notorder si ;:ply call:' Px Products Controlled Substances: M Medical 1-8 Regulatioris mquire us to limit ft sat o of '.x and on'r llnd substance orliy to registered, iicer;sed healthcare pm tessionals. If you are a new customer or have rec- antl.l moved, please turnish us -;itl; a rcp, of ;cur updated s fate e istration. For controlled sufrstances, k :mish a copy of your DEAD ccrtif cafe, verifying yg.,. shipping address. Glass 11 druf s can he ordered only by n ail. International Orders: Please Note: :`opened handpieces and equipment may not he returned for We proudly Serve healthcare: Jrofe ss €onals nd governments t1 r :,ughcut the .rorld, o puce orders or or f it rt: r es on expo t credit. f r t tp il! k)u rE3pair >ed or rsplacF d in accordance ar ce .rith terms ar d coneitlo s. clease c ntact our lnterrlational Depa try ent: Mnufactr rer 4r arrant' s, Be.k-,rt open €'ig ha dpiec :-s or 8i C °845 u eq uipment, ,a.e s agest that you heck fhe shippOci ;o? miner and packing list to veri=;, tha ycrr a e receiwed exactly what Prescription Drag Returns Instructions: you crdered.0pened Computer Software is not returnable. ether restrictions may also apply, a Ref urn Authorization is Required for ali. 'Pres ripl on ifugs. Simp lil calf our Cust omer Service Department t `l'•,i:i�i?u�? °v'7Jc1, 11 €.,.:aV...G ?�..........�.....w.s.,a.�H. .,a.,>.,.'� a >,.....,,,..,c. n..,�....,,,w.k. a...,.,s,._.�. ••..�....;,ru;2- „a,,**�.,. szLz= z,. w,,,...,.... ....,,.w,.L..�`xsc_....,,..,.a. e ._w&._.... :m 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)) 7150538 -01 $46.30 1407289 -01 $1,069.34 9782287 -01 I I $2,829.00 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 $3,944.64 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. I ACCT #/TITLE I AMOUNT Board Members 1120 7150538 -01 1 102 390.11 j $46.30 1 hereby certify that the attached invoice(s), or 1120 1407289 -01 102 390.11 $1,069.34 bill(s) is (are) true and correct and that the 1120 I 9782287 -01 1 102 390.11 I $2,829.00 materials or services itemized thereon for which charge is made were ordered and received except APR 23 2042 �P zA onw g A 0 'G Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund