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210395 07/05/2012 a CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $4,430.95 PALATINE IL 60055 -0241 CHECK NUMBER: 210395 CHECK DATE: 7/5/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 5051065 -01 2,475.10 SPECIAL DEPT SUPPLIES 102 4467006 6582671 -01 393.10 EMS EQUIP 102 4239011 7133232 -01 21.00 SPECIAL DEPT SUPPLIES 102 4239011 7135193 -01 1,541.75 SPECIAL DEPT SUPPLIES HSI ORDER# ORDER DATE DUE DATE 01427184 06/18/12 07/18/12 D& B #:01 -243 -0880 WHSE DEA# RHO162494 Fed ID: 1 1- 3 136595 ff his order ias been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 1 107 -0530 100 /BX PURPLE NITRILE PF GLOVE LARGE 60 60 C 8.65 519.00 6 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 153 -6483 RX 250ML /BT STERILE WATER FOR IRRIG 250ML 48 48 C 1.10 52.80 8 N PEDIGR E ITEM. ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. DC:0033800 402 3 891 -3037 U 50 /CA IV PREP KIT W/ TEGADERM 6 6 C 61.19 367.14 14 ASE'GOOD,I EM, MAY BE SHIPPED'-SEPARATELY. 4 555 -5396 U EA PROTECTIV ACUVNC SFT CATH 20X1.25 200 200 2.73 546.00 15 5 654 -5076 U 50 /BX PROTECTIV ACUVANCE SAFETY 22GX1" 2 2 136.50 273.00 16 6 555 -1166 PU EA PROTECTIV ACUVNC SFT CATH 18X1.25 100 100 2.73 273.00 15 7 890 -6868 3 /PK LIFEPAK 12 PAPER EKG 24 24 10.67 256.08 15 8 507 -8362 X 100 /BX NACL PREFILL SYRINGE 10ML ST 2 2 38.00 76.00 16 N PEDIGR E ITEM. DC:6380701 010 9 499 -0526 EA WIRE LADDER SPLINT 24 24 4.67 112.08 17 BILL TO SHIP TO 11"VOICE4 INVOICE AM NT I ITEM STA "CUS KEY REM KEY 11308571 1817102 5051065 -01 2475.10 n- uackordercd:ucmwillfollow SK- school Kit D Discontinued; Item no longer available NC No Charge H I RDER ORDER DATE INVOICE DATE OF BOXES F special Schein Free Goods 18 12 6/18/12 1 7 M Manufacturer will ship Item directly to you 01427184 0 6 I' Prescription Drug: Return Authorization Required R Rcf6gerated Item: May be shipped separately CUSTOMER PQ# PA E special Schein Pricing U Temporarily unavailable: please reorder MARK 1 OF 2 'r- 'taxable Item Continued on Next Page L H ENRY IN SHIP TO /SOLD TO: EMS Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 I 540 W 136 St Station 46 Michael Kaufmann Carmel, IN 46032 -8806 0100007, 30857105051 ,0651,10010000002475100618123 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept HILL To I SHIP TO INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032 -7543 1308571 1817102 2475.10 INVOICE# INVOICE DATE 5051065 -01 6/18/12 CUSTOMER PO MARK Please detach hererind mail the above with your payment HSI ORDER# I ORDER DATE DUE DATE 01427184 06/18/12 07/18/12 D &B #:01 -243 -0880 WHSE DEA# RHO] 62494 Fed ID: 11-3136595 s y o x s e s 11 ......9 sE I a V 0.�_.,,. F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOJ DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE 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 SIJCH R EQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSI THE PURCHASE THAT E ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. N HENRY CHEIN, INC. HAS PURCHASED THE SPE IFIC UNIT OF THE PRESCRIPTION DRUG DIRECTLY F OM THE MANUFACTURER. MERCHANDI E TOTAL 2475.10 i nvoice Date 30 days 2475.10 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: H ENRY SCHEI4 INC. D EPT CH 10211 ALATINE, I 60055 -0241 BILL TO SHIP TO INVOICER INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 181710 2 5051065-01 2 4 7 5.10 13 liackordcred; Item will follow SK School Kit H I ORDER# ORDER DATE INVOICE DATE OF BOXES D Discontinued, Item no longer available NC No Charge P Special Schein Free Goods 01427184 0 6 18 12 17 M Manufacturer will ship Item directly to you p prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately C USTOMER PO# PAGE Special Schein pricing U Temporarily unavailable; please reorder MARK 2 OF 2 T Taxable Item LP300 r HENRY SCHEIN EMS R S 0 i Pa 8 �a,?.... We €hake every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog, hovvever. we reserve the right to make price adjustments in VIS MASTERCARD, DISCOVER and AMERICAN EXPRESS response to ma €�ufacturers` price changes ar J Guaranteed Satisfaction If you have tried a product and it is defective or does not perform Slif Your O rder o Yo Open Account satis`actorily, we will provide a credit, refund, or exchange; iPs your Availau e to licensed practitioners in the U.S. All invoices are choice. Simply call our cu ,comer service ctepa tment within 30 days payable t.ithir7 30 days. of receipt of the merchandise to arrange for the return. For a warranty repair or if you we sent SDnleihing you did not o rder, simply call: x Products Controlled Substances: Matra Medical -800- 845 -3550 Regulations require us to limit the sale of Rx and controlled substances only to registered, licensed healthcare professionals. It you are a n customer or have recently moved, please furnish us 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 tote: We proudly serve healthcare professionals and governm -rents Cpened handpieces and ecuip€r€ent may not be returned for throughout the world. To place orders or for inquiries on expor credit, but Y,i1I be repaired or replaced in accordance with terms and conditions, please co €,fact our International Department: manufacturer warranties, Before opening handpieces or 1- 800 845 -31550 equipment, we suggest that you check the shipping container and packing list to verify that you have received exactly what Prescription Drug Returns Instructions: ordered.Opened Cornputer Software is not returnable. Other restrictions may also apply, A Return Authorization thorization is Required for a Prescription (Drugs. Simply call Dur Custorner Service Department 1 8'i 3 5 50. 11 r• �a g'° ��t' 3 '�ezz Y ji a�i #ir\ HSI ORDER ORDER DATE DUE DATE 01507108 06/20/12 07/20/12 D &B #:01- 243 -0880 WHSE DEA# RHO 162494 Fed ID: 11-3136595 ME kv his order aas been processed by our MIDWEST ..C.' 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 1 602 -8100 EA COLLAR STIFNECK SELECT ADULT 50 50 C 5.95 297.50 1 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 496 -6428 100 /BX LANCET SURGILANCE GRAY 23G 1.8 3 3 10.00 30.00 2 3 101 -5979 6 /BX CLOTH SURGICAL TAPE 2 25 25 7.77 194.25 4 4 220 -1398 3 /ST BODY STRAP SET DISP YELLOW 200 200 5.10 1020.00 2 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR 0 HER 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. UPOR DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, TND UPON ANY S CH EQUEST, SUM VALUE MUST BE DISCLOSED AS A DI COUNT ),GAINSq THE PURCHASE THAT ARNED.SUCH VALUE. ACCORDINGLY, YOU_.SHOULD RE AIN TH SE RECORDS. MERCHANDI E TOTAL 1541.75 Invoice Date 30 days 1541.75 BILL TO SHIP TO INVOICE# INVOIC£- :AMOUNT ITEM STATUS KEY REM KEY 1308571 1817102 7135193 -01 1541.75 H Backordeied; Item will follow SK School Kit D Discontinued; Item no longer available NC -No Charge HSI ORDER ORDER DATE IiJry ICE bATE OF BOXES I'- Special Schein Ni ee Goods M Manufacturer will ship Item directly to you 015 0 710 8 0 6 /2 0 12 6/20/12 4 P Prescription Drug; Return Authorization Required CUSTOMER A PO PAGE R Refrigerated Item: May be shipped separately Special Schein Pricing U Temporarily unavailable: please reorder MARK 2 1 OF 2 T Taxable Item Continued on [Next Page.......... LP300 r z NR SCH SHIP TO /SOLD TO: EM Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 540 w 136 St Station 46 Michael Kaufmann Carmel,IN 46032 -8806 0],0000130857107],351931 ,1,001,00000015417506201,26 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept BILL TO I SHIP TO. INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032 -7543 1308571 1817102 1541.75 INVOICE# INVOICE DATE 7135193 -01 6/20/12 CUSTOMER PO MARK 2 Please detach here and mail the .above with your payment HSI ORDER# �ORDER DATE DUE :DATE 01507108 06/20/12 07/20/12 D &B #:01- 243 -0880 WHSE DEA# RH O 16 2 494 Fed 1D: 11-3136595 pg s Y 3zg r �sr lo t £d�� LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: ENRY SCHEI INC. EPT CH 102L1 ALATINE, I 60055 -0241 BILL To SHIP TO INVOICE NV IcE AMOUNT ITEM STATUS KEY T c P EM KEY 1308571 1817102 7135193-01 1541.7S H Backordered, Item will follow sho ol Kit HSI'� RDER ORDER DATE INVICE DATE B XES 1) Discontinued, Item no longer available N,Ilurge P- special Schein Pied Goods M Manufacturer will ship Item directly to you 01507108 06/20/12 6 2 0 12 4 p Prescription Drug; Return authorization Required CUSTOMER -PO PAGE R Refrigerated Item; May be shipped separately special Schein pricing MARK 2 2 OF 2 T- Taxable I nlm un please reorder LP300 9 HE I: ,�",�RMS 0, A- /e rn< e „tJery E tf{ t i„ m<rir�t<; pric for tf Cfilrat €n ,f a P ayment y CHECK car by the HENRY CH IN CREDIT CARD, casug, ho, =.ever, we reserve the right to make price adjustments ii. VISA, t1IASTERCARD, DISCOVER and A ERICA EXPRESS response to manufacturers` price changes Guaranteed Satisfaction: vrs,� If you have tried a product and it is detective or do-,s?-,)t perto!ul or satis`ac°'arily,'re will provi a credit, rebrid, or exchnn F Ws your choice, Shnio y' ca:l our Wor°:er service d4 ;a�rtr; r .Y °tri 130 days ai:au.M to l.�.ert5:d f.rat.tif i�I e.: r t... U.;;. ;�.s are 1 payable +r days, of receipt of Me rr�omhar dis o to arrange, for the return, Fora „'r,rraC�f ri' $'lir or if `d” %i e:re se'n Sonl tf1i II yC .l dI` riot C4i %r, si ~lf;ly nail:` x products Controlled Substances: Matrx Medical 1-8048450550 Rqulalb s mquire us to lint he sale of fRx and c =.,nfrofled suf sWnces only to registered, icemed healthcare professionals. if you are a new customer or have recently moved, ple ase. t:ve furnish us Mth a copy of your updated stag registration. For controlled sAstan furNA a copy c)': your DEA certificate. 'verifiyin 7 your sh ip{;ing address, Class li drugs %an: b ufrde7rE (F only by i International Ordem 'le no te° x k pmudl'y wrve flf afthcare; pr.,f: ssionals ant. governments W[ and eq �taY riot be Cut' {�:f f; :r r ,xjor or `J r._ t G' 8 nI�`. 4" M be E fs CE c w th the plac U• for "q es or' expo t :pa:s d ce r pfa d in acccrYanr. r An and conditior, please contact our International Department m �nUt< rtl 'i',C'v "1 :CCllltie ;5, B 7i :nl': i fii i f7iGt; ;s i7( -8,00-84 eclWpment, we suggest that you cllct,k the shipping co stainer and pacing list to verify that you hue mcei ae exactly what you crdered.Cpened Computer Scftviare is not returnable. P rescription Re turns Instructions: Other restrictions may also apply. A Return "?uthorJaWn is Required for all Prescrp ion Drugs. Simply call our worn ler servke Depar rnent hw shlmom F s HSI ORDER# 'ORDER DATE DUE: DATE 01508324 06/20/12 07/20/12 D &B #:01 -243 -0880 WHSE DEA# RHO162494 Fed ID: l 1- 3136595 IM e`'-$`^f`a f 1p E 'y F� his order has been processed by our MIDWEST D.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 1 777 -4466 12 /BX COBAN SELF ADH WRAP 3X5 NEON 1 1 21.00 21.00 1 F YOU ARE 3 ARTICIPATTNG IN A DISCOUNT PROGRA (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS "DISCOUNT WITH THIS PURCH SE YOU HAVE ARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPO DISCOUNT RECEIPT OR REDEMPTION, ARE RECEI ING OR WILL RECEIVE 'TICE OF T E DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, P.ND UPON ANY S CH EQUEST, SUM VALUE.MUST BE DISCLOSED AS A DI COUNT XGAINSI THE PURCHASES THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 21.00 I nvoice Date 30 days 21.00 LEASE NOTE NEW REMIT TO ADDRESS P lease remi payments only to the following a dress: 14 ENRY SCHEI4 INC. D EPT CH 10211 ALATINE, I 60055 -0241 BILL :T0 xIP! To iNvolcE INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 '/133232-01 21.00 H Backordered, Item will follow SK School Kit D Discontinued; Item no longer available NC No Charge HSI 'ORDER ORDER: DATE INVOICE DATE" OF B ES F Special Schein Free Goods 15 B 3 2 4 06/ M- Manufacturer will ship Item directly to you 6 2 0 12 1 P Prescription Drug; Return Authorization Required R Refrigerated hcm: May be shipped separately `CUSTOMER PO4 PAGE Special Schein Pricing U Temporarily unavailable: please reorder MARK 3 1 OF 1 T Taxable Item L m ake effott to prices for they duratioDof,,i Payment by CHECK or by Me HENRY SCHEIN CREEDIT CAS' D, ca' oao t­a rp.serve tlie right to make price 4ustr ews VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manuf-adurers' price, changes Guaranteed Satisfaction: or If vou have tF'ed a -DroAur" a:ld it is defedive or does r_)t oerform ovil: prov'de refund, a credit, refu or exchange Wsyour Avai'abio, to licensed r%ra(. Vw- US, A MVOICOS care :::r do'rte, Simp'vca'l our customer se vie de;'Artmen: ­"hin 30 days pa v a, bl fi Utii it 3 0 d avy s, o r�;cek of ilk� m u�chvd to, arrange for the to urn. For a a D _,m nIv u')oair or it vo. were serit, some Yo: I di"A not s It: 'a Rx Products Controlled Substances: M x Medical 1-800-845-3550 U Reamblions roquine us to limit the sa: of e x ano conIrdled substances only to registered ke! sed healthcare professionals. If you are a new customer or have receMlv moved, olease fur:%'Sh us 'ovith a coi)v of vour ivdatecl state re slration. For con tulle substw)ces Lumish a copy of your DEA shipfl.ing address. Class 11 drugs can be ordered omlv b'v n :a International Orders: Please Noter We proudly ser v, health are is and g vernrnie-rits ;i ;l Opened handpienles and equipment may not be returned for roughout the To pl qu ace orders or fu r es po C;; n ex rt credit bu' w:II bo repaired or ref%slaced in accor-olancev,,Ji ct ou� hiterna�' r U01a I Department rnanufactu' warrant,4� Beo qp toreni.ng handoiece�s o terms and nor.. iflons, please contK r equipment 8 0 0 8 4 5 3' 5 5 L n we s:..:ggkeczt trat vou check ihn shipp:::' .!!ainer and pa&ng list to verify that you r o :lave ecrive I exactly -ovihat Prescription Drug Returns Instructions: you wdered.0pened Computer Software is not returnable. other restrictions may also apply. A 'return Authorization is Required for all P escription Drp-:ps._ S,mply call our Customer Service Deparment 1­800-SA15'- 35'50, HSI ORDER ORDER DATE- DUE DATE 01506284 06/20/12 07/20/12 D &B #:01 -243 -0880 WHSE DEA# RHO 162494 Feed ID: 11-3136595 CONTAINS MULTIPLE S IN fF VOICES #r his order has been processed by our MIDWEST D.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 1 499 -9994 EA ULTRA SOFBOX PLUS ROYLBLU 2 2 196.55 393.10 1 HIS PRODUC IS BEING SHIPPED FROM OUR NORTHEAST DIS RIBUT ON CENTER. OUR ORDER 1506284 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE FTEMS IHEN THEY ARE HIPPED. F YOU ARE ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR O HER 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. UPON DISCOUNT RECEIPT OR REDEMPTION, 'IOU ARE R9CEI OR WILL RECEIVE OTICE OF TIE 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 REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINSI THE PURCHASE THAT ARMED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 393.10 invoice Date 30 days 393.10 BILL TO SHIP TO INVOICE 11110 ICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 6582671 -01 393.10 13- Backordered; Item will folluw SK School Kit D Discontinued; Item no longer available NC No Charge HSI :ORDER ORDER: DATE INVOICE: DATE:: F' BOXES P Special Schein Prec Goods 2 0 12 6/20/12 2 M- Manufacturer will ship Item directly to you 01506284 0 6 P Prescription Drug: Return Authorization Required 'CUSTOMER PO PAGE R Refrigerated Item; May be shipped separately Special Schein Pricing U Temporarily unavailable; please reorder MARK -1 1 OF 2 T Taxable Item Continued on Next Page LP300 U.-"E.NRY SHIP TO /SOLD TO: EMS INVOIC Carmel Fire Dept Head Quarters MI 135 Duryea Road, Melville, NY 11747 z civic Sq Carmel,IN 46032 -2584 0100001, 30857106582671 ,1100100000003931006201,25 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032 -7543 Carmel Fire Dept BILL TO I SHIP TO INVO 2 Civic Sq ICE AMOUNT Carmel, IN 46032 -7543 1308571 1308572 393.10 INVOICE INVOICE.DATE 6582671 -01 6/20/12 CUSTOMER PO MARK -1 Please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 01506284 06/20/12 07/20/12 1)& B #:01- 243 -0880 WHSE DEA# RH0162494 Fed ID: 11-3136595 fR« NOW 6 1 10 3 .3�' �9 Y "�s({ >.,^.N 9 k"£ !in....`p Rt OkiFFi LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following address: H ENRY SCHEIR INC. EPT CH 10211 ALATINE, I 60055 -0241 SILL TO SHIP TO INVOICE4 INVOICE INVOICE AM OUNT ITEM STATUS KEY REM KEY 1308571 1308572 6582671 -01 393.10 H Backordered: hem will follow SK School Kit HSI "ORDER ORDER' DATE INV I E D AT E 4 OF BOXES D Discontinued: Item no longer available NC No Charge F Special Schein Fiee Goods 01506284 06/20/12 6/20/12 2 M- Manufacturer will ship Item directly to you P Prescription Drug: Return Authorization Required R Refrigerated Item: May be shipped separately CUSTOMER PAGE Special Schein Pricing U Temporarily unavailable: please reorder MARK -1 2 OF 2 T Taxable Item LP300 HENRY SCHEIN EMS :8 'Ahe rn: ke every effo' iv maintain; prices for tI a durafior� of a Payment by CHECK or the HENRY SCHEI CREDIT CARD, cat oc�, l'owever, we reserve the ri h° to make price adjustments VISA, MASTERCARD, DISCOVER and AMERICAN EXPRESS response to manufacti:rers' price ctlanoes Guaranteed Satisfaction: vrsa,. R. If licu. have tr ed a product ai :d it Is defedve or does :ot c)erforn. or satisfaciorih we will orvv de a credit, refund, or exchan its ,o €r l rro n ,a €fab to license f.raGtit. r t. U.S, �....tvoines are choice. S O 'call our custon er scr; ice deiArt°y ertl fMi; i '30 Mars p' a; <:ble !with n of mcci.pt of the rnerc �a:%diso to arrange: for the return, For a 4.''arrdnty reDalr or if v=„i were sent sonic1ling you did not ordo :r, S impl y call: x Products Co ntrolled Substances: Matrix Medical 1- 800 045 -3550 Re gulatior s req +giro: us to lim the sai of x <tnc' oor truII d substances nniv toreaistered. licensed healthcare professionals. It you are a nerd customer or have recentl%i oved, please iur'". :s'i us i'vilh a copy of your updated s °ate reg sera ion. Fvr controlled SUbstance fr rnivh a copy of your DEA certificate, verifying yor<r ftrli a d dr ess, C II d€'L:QS ca be ordenod o nly t Y'a 1, International Orders: Please mote: v4 pioudly 4 ,r'v healthcare care: f :ss €onials all,: gcverri its Opened handpieces alto equipment May nc:t be reLirned kor t' t(cughcut t ?te vFor d, p dc2 orders or for l q:i r es cn expoirt credit. L,�ut I t,e repa red or replaced in accordance h 2rn,s WIC, �c€ cl1 :ons, idease on'v t c;cf i ierlt :!anal p iriltfent: matl.ltactl ref varrantlle -s. Bokor i copening ha iec—e or er:uipment s aQest that ou ::heck the shipping co llainer a nd packing list to verity' t ha' lave received: exactly s hat you crdered.Opened Computer Softviare is not returnable. re cri ion Drug Returns Instructions: Other restrictions may also apply. A. Return Authorization is Required for all Prescription :}rugs. S "ply call our vus :orner Service Depar:rTient 1 ­800 8 4 E -3550, 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)) 7133232 -01 $21.00 7135193 -01 $1,541.75 5051065 -01 I I $2,475.10 I 6582671 -01 I I $393.10 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 N W ARRANT NO. ALLOWED 20 Henry Schein IN SUM OF Dept Ch 10241 Palatine, IL 60055 $4,430.95 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 7133232 -01 102 390.11 $21.00 1 hereby certify that the attached invoice(s), or 1120 7135193 -01 102 390.11 $1,541.75 bill(s) is (are) true and correct and that the 1120 I 5051065 -01 1 102 390.11 I $2,475.10 materials or services itemized thereon for 1120 I 6582671 -01 1 102 670.06 I $393.10 which charge is made were ordered and received except jUN 2'9 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund