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Home My WebLink About216733 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 _ ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,604.98 CARMEL, INDIANA 46032 DEPT CH 10241 PALATINE IL 60055-0241 „o CHECK NUMBER: 216733 CHECK DATE: 1/29/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 2565941-01 546 . 00 SPECIAL DEPT SUPPLIES 102 4239011 3834546-01 1, 058 . 98 SPECIAL DEPT SUPPLIES Please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 06283244 01/07/13 02/06/13 D&B#:01-243-0880 WHSE DEA# RH0162494 Fed ID: 11-3136595 ' s e s �... a sn^ s ;� a"a s °�a � mi' �; � `.:a �€: �`.3�•, s�.,- °� ;, e : ortheast D stribution Center 1 WEAVER ROAD ENVER, PA 17517 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 1058.98 Invoice Date + 30 days 1058.98 LEASE NOTE NEW REMIT TO ADDRESS lease remi payments only to the following a dress: ENRY SCHEI4 INC. EPT CH 10211 ALATINE, I 60055-0241 BILL TO SHIP TO INVOICE INVOICE# INVOICE ITEM STATUS KEY TR EM EY 13 0 8 5 71 181710 2 3 8 3 4 5 4 6-01 10 5 8 . 9 8 H-Backordered:Item will follow ho-Discontinued:Item no longer available No Charge HSI R -RDE - INVOICE E F-Special Schein Free Goods VMARK 01/07/13 1/07/13 11 M-Manufacturer will ship Item directly to you P-Prescription Drug:Return Authorization Required — R-Refrigerated Item:May be shipped separately .. MER P � � - .: PA E ,>. $-Special Schein Pricing U-Temporarily unavailable:please reorder 2 OF 2 T-Taxable Item Payn--�ent Terms: We make evervaffort tomainta:n dmot:on of Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, notabghowovor�womonmntha richt to make pricaadjuotmmnts|n VISA,MASTERCARD.DISCOVER and AMERICAN EXPRESS renponnetomanufactumm'phnoohengeo Guaranteed Satisfaction: or Ifvou.have(hadaomduct and i|in detective nr does not pedunn m Bill Y,.-�ur Order To Your Open Account eUn|adoh{y.wn will pmvidna credit,refund,or exchange- foyour choice. Simphvcm||ourcuSIomer service department n:'hi 38dayo payable within 30 days. dronaiptof the merchandise,to arrange'or the return. Fora warranty rppairorit you wamoent sonic-thing you did not order, �mp|yna|}: Rx Products & CoAty#|led Substances: MatKx Medical 1~800-845-3550 R } {| to|imk|hos�e�Rx and cnn|m/iod substances un|y10mgiutemd,|canuod healthcare pmtemdnnaln. If:you are a new customer o/have recently moved,0ease furnish substances,furnish a copy or your DEA certificate,verifying yo:Ur shipping address. Class 11 drur i .�S!,an be.ordered on1v b,,,:y ail. International Orders: Please _____ � Wepmudlyannmho��campnJ�miono!nanUgnvpmmano Opened hand r ~~and equipment may not returned inr mh | � � | | |muUuue�ud � 7npao nrnqo,anonoxpn � cr~dii'but will`~~'��ormp|�m 'accordance`'''h U �mmand unndi�m».p|�menun��our|n|enmdnoa|Dspa�me �: mu no/ac��rwerun eu,Bo�nmopnmng p 1-8O0-845'36S0 equipment,we suggest that h kthoohipi liner onUpuukinglist tu verify\hatYou hovoreceived.exactly what �mo�ned.OpenadCom be Software io not returnable. ��8�� [W� ��t;�Ug !��n�� Other restrictions may also apply. A Return Au1torize1|nn is Required*,orall P,nuo,�hnn Drugs.3|mp|yno|| our Custioma,Spnioa Dopor'ment @ 1-800-845'3550. Lp30o HRDER ORDER DATE DUE DATE 0SI 628 O3228 01/08/13 02/07/13 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 '4 a' "t 9 R : r 5 3 t his order has been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 17-571-266 1 499-0650 EA BREATHSAVER ULTRA ROYBLUE 2 2 C 273.00 546.00 2 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. OUR ORDER 6283228 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED SEPARATELY. YOU WILL BE BILLED FOR THESE TEMS 1AHEN THEY ARE SHIPPED. 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 CREDI TOWARD GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE IN ACCO DANCE WITH DISCOUNT PROGRAM RULES. UPOF DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF THE DISCOUNT VALUE. FROM TIME TO TIME, MEDICARE, MEDICAID, TRZ ARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH VALUE, PND UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS THE PURCHASE THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. MERCHANDI E TOTAL 546.00 Invoice Date + 30 days 546.00 BILL TO SHIP TO INVOICE INVOICE# INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 2565941-01 546 .00 x-Backordered:Item will follow SKSchool Kit D-Discontinued:Item no longer available NC-No Charge HAT ORDERif RDER DATE INVOICE DATE # OF BOXES F-Special Schein Free Goods 06283228 01/08/13 1/08/13 2 M-Manufacturer will ship Item directly to you P-Prescription Drug:Return Authorization Required ER PO PA E R-Refrigerated Item;May be shipped separately $-Special Schein Pricing U-Temporarily unavailable:please reorder MARK 1 OF 2 T-Taxable Item Continued on Next Page.......... IE ICY SCHEI co 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 0100001,308571025659411],00],0000000546000108136 BILL TO: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032-7543 Carmel Fire Dept BILL To I SHIP To I INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032-7543 1308571 1308572 546 .00 INVOICE# INVOICE DATE 2565941-01 1/08/13 CUSTOMER PO � MARK Please detach here and mail the above with your payment HSI ORDER# I ORDER DATE DUE DATE 06283228 1 01/08/13 02/07/13 D&B#:01-243-0880 WHSE DEA# RHO 162494 Fed ID: 11-3136595 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following address: ENRY SCHEI4 INC- EPT CH 10211 ALATINE, I 60055-0241 HILL TO SHIP TO INVOICE# INVOICE ourrr ITEM STATUS KEY REM KEY 1308571 1308572 2565941-01 546 .00 It-Hacl:ordered:Itemwillfollow FIK-Schoolxit ER RD E NV A E D-Discontinued:Item no longer available C-No Charge P-Special Schein Free Goods 06283228 01/08/13 1/08/13 2 A9-Macripti nDrn will Return Authorization you P-Prescription Drug:Retum Authorization Reyuired T ME 0 E R-Refrigerated Item:May be shipped separately $-Special Schein Pricing MARK 2 O F 2 T-Taxable Item unavailable:please reorder A HENRY SCHEIN" TERM OF ALE EMS Payment Tenrns� We make every effort lo maintain pricestor the duration ofa Payment by CHECK or by the HENRY SCHEIN CREDIT CARD, catalog howover,weeaomotha phoaadjustnonts|n r VISA,MASTERCARD,DISCOVER and AMERICAN EXPRESS esponse tomanufactumm/�hnouhan0ou Guaranteed Satisfaction: or If vou have tried apmdu�and itindo(ndivenrdoaonu1pedu,m Bill Your Order To Your Open Account oaUu"adnri|y.wn wilt Provide a credit,refund,nraxrhanei(oynur Avai'able to licensed practitionorsin the U.S,Altinvoices are choice. Simply:m||our customer uomicedo A l thin3Udayx payabie within 30 days, ofnzuiyfd the momhood|oo�a�mo0ofo/�em�m. For �mm��pairorif you womoe�momohing you d�n�o�n/. simply call: Rx Products & Controlled Substances: Matyx Medical 1~800-845-3550 Regulations require osbiimi�|hom&eofRx and controlled substances only to registered,licensed healthcare professionals, U you are a new customer ur have moanU od olease furnish substances,I!—rnish a copy of your DEA certificate,verify:,, shipping address, Class 11 druc-scan be ordered on1v b,,-ail. International Orders: Please Note: Wn proudly serve haa|\,carepmfeoaiunu!s and governments Opened handpieceo and equipment may not boret:med|or thmuOhout|hewodd Tnp|ane orders nrfn/inqo|rannnoxpn.1 credit,but wi|!bn repaired or replaced in accordance with terms and uondidnna |�menno�dour|ntema|inne|Depa�nnot manufacturer mo,B� mupno�ghu:dPiecesnr 1�OO�4S'36�� '~ eqUipmont weuoggost that o chxkh | | iner andpuoNng||nt to verify mve� h d exactly what ymm�ned�penedCom 0e So�wmm»in not returnable. ��i�ti�� t�yn� �M��W�ti�� Other restrictions may also apply. ARpfium Authorization inRequimdfo,all Preoohphno Drugs,Si? p}ycall our Customer Service Department @1-80O-O45'3550. L'300