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Home My WebLink About214673 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $4,413.32 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055-0241 CHECK NUMBER: 214673 CHECK DATE: 11/2012012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 60448646-01 3 , 471 . 32 SPECIAL DEPT SUPPLIES 102 4239011 8185370-02 41 . 40 SPECIAL DEPT SUPPLIES 102 4239011 9124090-02 900 . 60 SPECIAL DEPT SUPPLIES HSI ORDER# ORDER DATE IDUE DATE 04738186 10/31/12 11/30/129 D&,B#:O 1-243-0880 WHSE DEA# RHO 162494 ".4 —4 rhis order has been processed by our MIDWEST D.C. 5315 WES" 74TH 3TREET INDIANAPOLIS,IN 46268 1 486-8840 10/PK GAUZE ST PLSTC TRAY 4X4 12 PLY 256 256 C 0.77 197.12 2 --ASE GOOD ICEM, MAY BE SHIPPED SEPARATELY. 2 360-1359 EA SAM SPLINT ORANGE/BLUE 36X4.25 24 24 6.50 156.00 28 3 935-6155 SO/PK BLUE SENSOR SP ELECTRODES 120 120 11.55 1386.00 27 4 891-3037 PU 50/CA IV PREP KIT W/ TEGADERM 10 10 C 60.00 600.00 12 --ASE GOOD ITEM, MAY BE SHIPPED SEPARATELY. 5- 107-0530 100/BX PURPLE NITRILE PF GLOVE LARGE 80 80 C 8.60 688.00 20 --ASE GOOD IrEM, MAY BE SHIPPED SEPARATELY. 6 107-0540 90/BX PURPLE NITRILE PF GLOVE X-LARGE 40 40 C 8.60 344.00 24 --ASE GOOD IrEM, MAY BE SHIPPED SEPARATELY. 7 782-6449 EA RESUSCITATOR BAG MASK DIS ADULT 12 12 C 8.35 100.20 26 --ASE GOOD ICEM, MAY BE SHIPPED SEPARATELY. ............ ------------- IF YOU ARE PARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER SPECIAL AWAZDS ("DISCOUNT")) , WITH THIS PURCHkSE YOU HAVE EARNED A CREDI— TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, 170U ARE RECEI ING OR WILL RECEIVE OTICE OF THE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE,-1 MEDICAID, TRI I ARE OR BILL TO SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY REM o KEY 11308571 1817102 6044846-01 3471 .32 n-13ackordered:Item will follow HSI ORDER ORDER DATE INVOICE DATE # OF BOXES 1)-Discontinued:It-cm no longer available I -Special Schein I-rue Goods M-Manufacturer will ship Item directly you 10/31/12 28 p-Prescription Drug;Return Authorization"81" 10/31/12 Require) CUSTOMER PO# R-Refrigerated Item:May be shipped separately PAGE# $-Special Schein Pricing U-Temporarily unavailable:please reorder MARK 1 OF 2 T-Taxable Item Continued on Next Page.......... HENRY SCHEIV SHIP TO/SOLD TO: EMS Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 INVOICE 540 W 136 St Station 46 Michael Kaufmann Carmel,IN 46032-8806 0100001308571060448461,1,0010000003471321,031120 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032-7543 Carmel Fire Dept BILL To I SHIP TO INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032-7543 1308571 1817102 3471 .32 - INVOICE# I INVOICE DATE 6044846-01 10/31/12 CUSTOMER PO MARK Please detach here and mail the above wnh yourpaymem HSI ORDER# ORDER DATE DUE DATE 04738186 10/31/12 11/30/12 D&B#:O 1-243-0880 WHSE DEA# RH0162494 W. .W &$ .- YT;' t'9�r;.�n*N'j 3`.. 3yis i c��f�.�:.t`.� •�''' �P'�a, + e b via,i. � ° 0 GU THER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DISCOUNT GAINSI THE PURCHASES THAT EARNED SUCH VALUE, ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 3471.32 Invoice Date + 30 days 3471.32 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEI4 INC. DEPT CH 10211 ALATINE, I 60055-0241 BILL To sxlP TO INVOICE INVOICEff INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1817102 6044846-01 3 4 71.3 2 13-Backordered:Item will follow SK-School hit H I ORDER# ORDER DATE INVOICE DATE # OF BOXES D-Discontinued:Item no longer available NC-No Charge 1-.-Special Schein Free Goods 04738186 10/31/12 10/31/12 28 NI-Manufacturer will ship Item directly to you P-Pmscnption Drug:Return Authorization Required CUSTOMER PQ# PAGE R-Refrigerated Item:May he shipped separately $-Special Schein Pricing MARK U-Temporarily unavailable:please reorder 2 OF 2 T-Taxable Item it 3 -z HENRY SCHEIN' EMS t'3 ,° ry F A' I ____....................___..__.._____...._.._.........._..........__......r_____...._.._..__..._.........__.._..___.._________________Payment Teruns: 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 rig ht to nuke 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 13111 € r Order 'a` :cFr } era :< ;tint satisfactorily,we will provide a credit,refund,or exchange,its your choice. Simply call our customer service department within 30 days Available to licensed practitioners in the J.S.All invoices are of receipt of the merchandise to arrange for the return. Fora payable within 30 days. warranty repair or if you were sent something you did not order; simply call: Rx Products & Controlled Substances: Matrx Medical -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 it drugs can be ordered only by mail. International Orders: Please Nate: We proudly serve healthcare_prcfessionais and governments_ Opened handpieces and equipment may not be returned far throughout the world. To place orders or for inquiries on exporE` z — credit,brat will be repaired or replaced in accordance with manufacturer warranties,Before opening handpieces or terms an conditions,please contact our International Depart„e,t: equipment,we suggest that you check the shipping container 1-800 d 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 all Prescription Drugs.Simply call our Customer Service Department @ 1-800-845-3550. Y ... :. _ LP300 HS I OR 2p'# ORDER DATE DU DATE 04628073 10/25/12 11/25/12 D&,B#:01-243-0880 WHSEDEA# RHO162494 CONTAINS MULTIPLE INVOICES s- ", n 0 his order as been processed by our MIDWEST D.C. 5315 WES" 74TH 3TREET INDIANAPOLIS,IN 46268 1 698-1246 EA QUICKTRACH EMER CRICOTHRO STERILE 6 6 150.10 900.60 1 IF YOU ARE 3ARTICIPATING IN A DISCOUNT PROGRA]l (E.G. , POINrIS, GIFTS OR O SPECIAL AWAZDS ("DISCOUNT") ) , WITH THIS PURCH SE YOU HAVE EARNED A CRED Ir' TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N AC=DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL RECEIVE 40TICE OF THE DISCOUNT VALUE. FROM TIME TO TI E, MEDICARE, MEDICAID, TRITARE OR DTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, P.ND UPON ANY STCH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS I THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD R E'AIN T HSE RECORDS. 14IF: MARK HJIETT MERCHANDI! E TOTAL 900.60 Invoice Date + 30 days 900.60 PLEASE NOTE NEW REMIT TO ADDRESS Please remi-- payments only to the following aldress: HENRY SCHEI4 INC. DEPT CH 10211 PALATINE, 1, 60055-0241 BILL TO SHIP TO — INVOICE IWOICE AMOUNT — ITEM STATUS KEY ('--REM-KEY 1308571 1308572 9124090-02 900 .60 13-Backordered:Item will follow SK-School Kit )-Discontinued,Item no longer available NC-No Charge H ORDER# ORDER DATE INVOICE DATE # OF BOXES 1' Special Schein free Goods M-Manufacturer will ship Item directly to you 04628073 10/25/12 10/26/12 1 13-prescription Drug:Return Authorization Required CUSTOMER PO# R-Refrigerated Item:May be shipped separately $-Special Schein pricing U-Temporarily unavailable:please reorder OF 1 T Taxable Item raymew tr,[Ulb, 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: It 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 Youi Order To Y-or Open Acc,,3kint 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: Matra 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 11 drugs can be ordered only by mail. International Orders: Please Note: Opened handpieces andequipment-nay not be returned for We proudly serve healthcare professionals and governments credit,but will be repaired o.r replaced in accordance with throughout the world. To 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 all Prescription Drugs.Simply call our Customer Service Department @ 1-800-845-3550. 0 Z '6 0 J111 U- L LP300 HENRY SCHEIV {C SHIP TO/SOLD TO: EMSCarmel Fire Dept Head Quarters MI 135 Duryea Road, Melville, NY 11747 I I\ ,®� 2 Civic Sq y �/ Carmel,IN 46032-2584 0100001308571091240901],003000000090060],0301,20 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032-7543 Carmel Fire Dept BILL TO SHIP TO INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032-7543 1308571 1308572 900.60 IDIVOICEq INVOICE DATE 9124090-03 10/30/12 CUSTOMER PO Please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 04628073 10/25/12 11/29/12 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 1 1-3136595 " ME . z..,r. -Y ;t'z'•^.: X w,�,. €�; .ss•. ^ <^ . his order ias been processed by our MIDWEST D.C. 5315 WES 74TH TREET INDIANAP LIS,IN 46268 1 862-2940 EA QUICKTRACH PEDIATRIC STER SINGUSE 6 6 150.10 900.60 1 F YOU ARE 3ARTICIPATING IN A DISCOUNT PROG (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS ("DISCOUNT") ) , WITH THIS PURCHASE YOU HAVE EARNED A CREDIII TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEIVING OR WILL RECEIVE 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 EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. /F: MARK H IETT ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDISE TOTAL 900.60 nvoice Date + 30 days 900.60 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: HENRY SCHEI4 INC. DEPT CH 10211 ALATINE, I 60055-0241 BILL TO SHIP TO INVOICE# INVOICE AM ITEM STATUS KEY REM KEY 1308571 1308572 9124090-03 900.60 13-Backordewd:Item will follow I SK-school Kit H I ORDER# RDER DATE INVOICE DATE # OF BOXES D-Discontinued:Item no longer available l, NC-No Charge 1=-Special Schein Free Goods 10/30/12 ] M-btanufacmrer will ship Item directly to you 04628073 10/25/12 P-Prescription Drug:Return Authorization Required T MER P PA E R-Refrigerated Item:May be shipped separately -special Schein!Tieing U-Temporarily unavailable,please reorder 1 OF 1 T-Taxable Item -------- ------- —777- HENRY S I EMS AU .............. ----------............................ Pay rnei it'rernis: We make every effort to maintain prices for the duration of a Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog,however,vve 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 detective or does not perform or Bill Your Order To Yv tit'Open Accc)wnt satisfactorily,we will provide a credit,refund,or exchange;it's your Available to licensed practitioners in the U.S.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 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 11 drugs can be ordered only by mail, International Orders: Please Note: Opened handpieces 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. To place orders or for inquiries on export manulacturer warranties.Before opening handpieces or terms and conditions,please contact our International Department: 1-800-8455-3550 equipment,:^:e suggest that you check the shipping container and packing list to verity 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 Prescription Drugs.Simply call our Customer Service Department @ 1-800-845-3550. 7-, 7 0 a LP300 HSI ORDER# ORDER DATE IDUE DATE 04318084 10/16/12 12/05/121 D&B#:01-243-0880 WHSE DEA# PG0229321 Fed ID: 11-3136595 his order has been processed by our GIV D.C. 80 SUMMI" VIEW ANE BASTIAN VA 2434 14ARK HUIETT 1 499-9037 EA 2PC S'METAL PB/SC-SPECIAL 20'/40' 4 4 10.35 41.40 1 kNDREA AND KO / MORRISON ------------- IF YOU ARE ARTICIPATING IN A DISCOUNT PROGRA14 (E.G. POIN S, GIFTS OR OTHER SPECIAL AWAZDS ("DISCOUNT")) , WITH THIS PURL SE YOU HAVE EARNED A CREDI" TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, YOU ARE RECEI ING OR WILL RECEIVE .11OTICE OF TIE DISCOUNT VALUE. FROM TIME TO TI E, MEDLCARE, MEDICAID, TRIOARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, P.ND UPON ANY STCH REQUEST, SUM VALUE MUST BE DISCLOSED AS A DI COUNT AGAINS I THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE-AIN THESE RECORDS. MERCHANDI E TOTAL 41.40 Invoice Date + 30 days 41.40 LEASE NOTE NEW REMIT TO ADDRESS Please remi: payments only to the following aldress: HENRY SCHEI4 INC. DEPT CH 10211 PALATINE, IL 60055-0241 BILL TO SHIP TO - INVOICE4 INVOICE AMOUNT ITEM STATUS KEY FREMKEY 1308571 1308572 8185370-02 41.40 13-13ackordered:Item%vill fellow SK-School Kit H ORDER# ORDER DATE INVOICE DATE # OF BOXES 1)-Discontmucd:Item no longer available NC-No Charge F-Special Schein Free Goods NI-Manufacturer will ship Item directly to you 04318084 10/16/12 11/05/12 1 11-Prescription Drug:Return Authorization Required O# PAGE# R-Refrigerated Item:May be shipped separately CUSTOMER P $-Special Schein Pricing U-Temporarily unavailable:please reorder r;ZK 1 OF 1 T-Taxable Item LP300 Ne make every effort Nmaintain prices for the duration ofu Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog,however,wereserve the right to make price adjustments in VISA,MASTERCARD.DISCOVER and AMERICAN EXPRESS response tomanufactomrs'pduechanges Guaranteed Satisfaction: If you have tried a product and itiu detective ur does not perform or satisfactorily,wo will pmvidea credit,refund,or exchange;it's your Available to licensed practitioners in the US,Ali invo:ces are choice. Simply call our customer service de rt nt within 30days of receipt of the morhandiaotn arrange for the return, For warranty repair ori[you were sent something you did not order, aimplyoak� � Rx Products & Controlled Substances: Matrx Medical 1~800~845~3550 Ragu|ehuos require to limit the sale of Hx and controlled substances on|yto registered,licensed healthcare professionals. It you are a new customer urhave recently moved,please furnish us with a copy of your updated state registration. For controlled substances,furnish a copy of your DEA ccertificate,verifying your shipping address. Class 11 drugs can be ordered only by mail, International Orders: Please Note: We.proudly serve hea|thnarppmfesainna|o and governments Opened hand pieces and equipment may not be returned for 1hwughouf the world. To place orders or for inquiries or,,export credit,Uutwi|\be repaired nrrep\acedin accordance with terms and conUihono.please manufacturer warranties,B�nmnpen�ghandPi�esor 1-800-845-3550' �0O846'S5S8 ' � equipment,we suggest that you check 1h hip i container and packing list toverify that you have received exactly what ��i��i�� Returns Instructions: you n�o�dlJpanmd�om *erSoftwuoe}mnntreturneb>e. ' Other restrictions may also apply. A Return Authorization ia Required for all Prescription Drugs.Simply call our Customer Service Department @1-800-845'3550, \ VOUCHER NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 $4,413.32 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 60448646-01 102-390.11 $3,471.32 1 hereby certify that the attached invoice(s), or 1120 9124090-02 102-390.11 $900.60 bill(s) is (are) true and correct and that the 1120 8185370-02 102-390.11 $41.40 materials or services itemized thereon for 1120 102-390.11 which charge is made were ordered and received except NOV 16 2012 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)) 60448646-01 $3,471.32 9124090-02 $900.60 8185370-02 $41.40 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