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Home My WebLink About212236 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CARMEL, INDIANA 46032 DEPT CH 10241 CHECK AMOUNT: $1,210.69 PALATINE IL 60055-0241 CHECK NUMBER: 212236 CHECK DATE: 8/28/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 15893961 -84 . 86 SPECIAL DEPT SUPPLIES 102 4239011 4286221 196 . 55 SPECIAL DEPT SUPPLIES 102 4239011 4638251 1, 099 . 00 SPECIAL DEPT SUPPLIES HSI ORDER4 ORDER DATE DUE DATE 02068194 07/16/12 09/02/12 D&13#:01-243-0880 WFISE DEA# RH0162494 Fed ID: 1 t-3136595 ARK 317-57L-2663.. S 17-428-878 IRON DUCK D ES NOT HAVE THE RED IN STOCK TODA /ETA 2-3 WKS 991860 (32Q5-RD) ---------- --------------------------------- ------ ---- ------------- ------- 1 499-1860 EA ULTRA SOFT BOX PLUS RED 1 1 196.55 196.55 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ---- ------------- ------- OUR ORDER 2068194 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS HEN THEY ARE HIPPED. F YOU ARE DARTICIPATIWG IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS ("DISCOUNT")) , WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, rOU ARE RECEI ING OR WILL R CEIVE OTICE OF T E DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, 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 AGAIWS THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 196.55 Invoice Date + 30 days 196.55 BILL.TO SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY Rhlvl KEY 1308571 1308572 5286221-01 196 .55 n-uaekordered:Item will follow SK-Scbool Kit D-Discontinued:Item no longer available NC-No Charge HST ORDER ORDER DATE INVOICE DATE OF PDXES p-Special Schein lice Cioods J%4-Nlanullacuuer will ship hem directly to you 02068194 07/16/12 8/03/12 P-MescriptionDrug;ReturnAuthorizationReyuired R Refrigerated Item,May be shipped separately -. CUSTOMER��PO = PAGE $ Special Schein Pacing MARL{ 071612 U-Tcmporaily unavailable:please reorder 1 OF 2 T-Taxable hem Continued on Next Page......... 2 rdrIEN T- RY SCREW"" SHIP TO/SOLD TO: EMS 135 Duryea Road, Melville, NY 11747 INVOICE 2a Civic FSge Dept Head Quarters MI Carmel,IN 46032-2584 0100001308571052862211100],0000000196550803125 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 1308572 196 .55 INVOICE - .SNVOICE DATE - 5286221-01 8/03/12 CUSTOMER-PO MARK 071612 Please detticli_iiercandggiil_thc_ahovc_with_y,our payment HSI ORDER# I ORDER.DATE IDUE DATE 02068194 07/16/12 09/02/12 1)&B#:01-243-0880 WHSL DEA# IZHO162494 Fccl ID: 11-3136595 ffl.W W s LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEIR INC. EPT CH 10211 ALATINE, I 60055-0241 BILL TO SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY REIN KEY 1308571 1308572 5286221-01 196 .55 li-Backordered:Item will follow SK-SchoolKit HSI ORDER ORDER DATE :INVOICE DATE F BOXES D-Discontinued:Itch no longer available NC-No Charge 1=-Special Schein Frce Goods bt-Manl11aelarCr will ship Item directly to you 02068194 0 7/16/12 8/03/12 P-14csciiption Ding:IZctnn Authorization Required R-Reliigcratcd hero:May be shipped separately CUSTOMER PO4 PAGE S-Special Schein Pr g m icin U-Teporl ily unavailable:please reorder MARK 0 71612 2 0 F 2 T-'Taxable Item .......... ........ ....-. ...................... ..-............................. .. .........._... . _.. HENRY4 ,?. > a, R EMS Y , _. ..... :. !r1;tke ever;`f fft r lo r aintais i i;;os`or th?durat o 'of a Paytnent by CHECK or by the HENRY SCHEIN CREDIT CAPD, ata4cu. : ,;e er, .,e reserve the r ui,f to I11ai{e;;rice adjustment; S i# A, F#4 ? A ?; DISCOVER and AMERICAN f respcnse'o manr_Itact rers'price chances VISA Guaranteed Satisfaction: or If vou have tried a oroduc:and it Is defective or noes„nt oerfor»14 B t s s tistac`c:rile,Yve will provide a credit,ref€.nd,or exchange Its ,oilir Avai abb to licensed practit. r. .s r.t U S , ....,..,r.< :>arE ,!a:'I:,e. :,I!rap:,pail u.1r�ustcrrter Sa!•rlve deii�r[r�er:tir::hlrr u'v:tars ,,� <<b:r ,,. '� c of rocr iut of the rrrerc aa!adis tc arrange fur the roturn. Fora I" ;ithin 3„days, rrant,re,fair or It vo e sE,t o yo t r ,Jo er4 .r: so :� •iu �;t ar4 a ply call: x Products & Controlled Substances: 1 trx Medical 1-800-845-3050 Hegulatior s roquire'us to limit the sale;f> x art;conir llnd substances oily to registered,licensed:healthcare professionals. If you area new customer c have rece?tl !neved. ease f€r?isli us with a copy of your updated state registration. For cdr trpiled substances,t€:rnish a copy of yf'ur DE;certificate,verifying V():. shipping address, glass ll dru+s can be ordered only b.,--ail. International Orders: Please Note: .................. '!Ye t:r�udly ,.n r;f;•?hF a Nlc arr;pr:ofn5.sionafs In novei�El.eiits Opened hand pieces and equipment pent r•:a' n(ot be,returned tr r '. p tt y throughout the.`world, Tc ace o?'ders ur`:7r i!':q::;1i- d, ex;vit oedit:but,.ill be repair>ed or re%[llacod in acc ardance avith p t F terms and conditions;please ccri°act our l terna ro!�at .;epartrtient manufacturer v.,arrant es,Motors o-penr'ig f a idp ec's or 8i{ 45 ;3uv et!iprtl'llt;we s?;ggest t"F;t',;;tl libel,(t'i e S 1p?i Cj.;C?'alder and ck:nQ list to venly tl a ,,eou have recei ec exactly what ro€r ordered.Openect Computer Software is not returnable, Prescription � Returns Instructions: Other restrictions may also apply. A Return Authorizak-is Required for all :Prescription Drugs. ;i 1ph,call cur Customer Service Depa:tanent ;1-800.8,1L5'-35% ,��; ^� (�- - �.�"�.,�..,,f�••r 1•„ .�`•s. ..��..'�,.. .. '��h �. ��>L,€�2� '? �"��t � } l«°3,��"'� � ; � k'�.if� ..� 1 4 � � a�p t��y I s s�;�g � � � � �-: i.. Yu I �.•,..•,.. �E¢..s...-...x.�.•....�.,e.,,.....✓.,w.». >a.....,«•�...w3.•,,.,,...•»...e..,...._w<w.,wwn..•ti..........'�..<8LSC.w....,,...w•:..�.»w•�...w..._.,......,.�,w,v_..v...w�. <..u....L.: ,.:&•.•....w...,.,....,...xu....�........,�w....::.,.;•••�:.x;....�..:�..a_. LP300 HSI ORDER11 ORDER DATE DUE DATE 02748322 08/13/12 09/12/12 D&B#:01-243-0880 WHSE DEA# RHO]62494 Fed ID: 11-3136595 This order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 RK 317-27 --2663 1 565-4216 100/BX NITRILE PF GLOVE BLACK XX-LRG 20 20 C 8.90 178.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 565-1031 100/BX NITRILE PF GLOVE BLACK LARGE 40 40 C 8.90 356.00 6 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 3 387-6081 EA ULTRA SPACE SAVER BOARD BLACK 2 2 C 282.50 565.00 8 HIS PRODUCP IS BEING SHIPPED FROM OUR WEST C AST DI TRIBU ION CENTER. —— - ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- F YOU ARE ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWA DS ("DISCOUNT")) , WITH THIS PURCH SE YOU HAVE EARNED A CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, 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 %GAINSq THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. estern Dis ribution Center 55 VISTA B VD PARKS, NV 39434 BILL TO SHIP TO INVOICE41 INVOICE AM ITEM STATUS KEY REM KEY 1308571 08572 4638251-01 109 9 .00 H-Hackodcred:Itemwillfollow SK-SchoolKit D-Discontinued:Item no longer available NC-No Charge H gj13 ORDER D TE INVOI E DATE F BOXE h-Special Schein Free Goods M-Manufacturer will ship Item directly to you 0 2 08/13/12 8/13/12 8 P-Prescription Drug:Return Authorization Required CUSTOMER P PAGE R-Refrigerated Item:May be shipped separately $-Special Schein Pricing U-Temporarily unavailable:please reorder T-Taxable Item Continued on Next Page.......... U HENRY SCHEIN8) SHIP TO/SOLD TO: EMS Carmel Fire Dept Head Quarters MI 135 Duryea Road, Melville, NY 11747 INVOICE 2 Civic Sq Carmel,IN 46032-2584 010000130857104638251110010000001099000813129 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 1308572 1099 .00 INVOICE# I INVOICE DATE 4638251-01 8/13/12 CUSTOMER PO MARK Please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 02748322 08/13/12 09/12/12 D&B#:01-243-0880 WHSE DEA# RHO]62494 Fed ID: 11-3136595 MERCHANDI E TOTAL 1099.00 nvoice Date + 30 days 1099.00 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEIq INC. DEPT CH 10211 ALATINE, I 60055-0241 ILL TO SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 4638251-01 1099 .00 H-Backordered:Item will follow SK-SchoolKit H RDER ORDER DATE INVOICE DATE F BOXES D-Discontinued:Item no longer available NC-No Charge I--Special Schein Free Goods M-Manufacturer will ship hem directly to you 02748322 08/13/12 8/13/12 8 P-Prescription Drug:Return Authorization Required T MER PO P E R-Refrigerated Item:May be shipped separately $-Special Schein Pricing U-Temporarily unavailable:please reorder MARK 2 OF 2 T-Taxable Item LP300 _ .. } Q HENRY SCHEIN"" __E'`^s-_________-___-- __-__---____________---____- -__-____-_ -__-_-_ -____------------TERMS-- -__-�_- ____-___ ___ _ ____ i -___ __ ______ ____ _______-_ _______________ _____ ............. ..........I....................................................................... ..................................... Pays-n rat Terrns: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog,however,we 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 product and it is defective or does not perform or satisfactorily,we will provide a credit,refund,or exchange;it's your Bill Your Order To Your Open Account choice. Simply call our customer service department within 30 days Available to licensed practitioners in the U.S.All invoices are of receipt of the merchandise to arrange for the return. For a payable within 30 days. 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 new customer or have recently moved,please furnish us with a copy of your updated state registration. For controlled substances,furnish a copy of your DEA certificate;verifying your shipping address. Class II drugs can be ordered only by mail. International Orders: Please Note: Opened ha,dpieces and equipment may not be returned for We proudly serve healthcare professionals and governments credit,but will be repaired or replaced in accordance with throughout the world. €o place orders or for inquiries on export manufacturer warranties.Before opening handpieces or terms and conditions,please contact our International Department equipment,we suggest that you check the shipping container 1-800-845-3550 and packing list to verify 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 al(Prescription Drugs.Simply call our Customer Service Department @ 1-800-845-3550.