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Home My WebLink About217175 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 357526 Page 1 of 1 ' 0 ' ONE CIVIC SQUARE HENRY SCHEIN INC CHECK AMOUNT: $1,624.15 8 1, CARMEL, INDIANA 46032 DEPT CH 10241 + '<,p� • PALATINE IL 60055-0241 CHECK NUMBER: 217175 CHECK DATE: 2/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 2449188-01 745 . 15 SPECIAL DEPT SUPPLIES 102 4239011 2449722-01 756 . 00 SPECIAL DEPT SUPPLIES 102 4239011 2565983-01 123 . 00 SPECIAL DEPT SUPPLIES HSI ORDER# ORDER DATE Di7E DATE 06956057 01/31/13 03/02/13 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 1 1-3136595 CONTAINS MULTIPLE INVOICES ®-. 0 k ,.t, f III. 6 C � `.A'k 8 6 p 6 .• his order ias been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 17-571-266 OFFICE 17-428-878 CELL 14ARK ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- 1 677-4617 EA MAGNUM BRASS REG W/FLOW 2 DISS 2 2 74.00 148.00 2 2 677-4617 EA MAGNUM BRASS REG W/FLOW 2 DISS 1 1 74.00 74.00 3 HIS PRODUCU IS BEING SHIPPED FROM OUR NORTHE ST DIS RIBUT ON CENTER. 3 672-4224 - -._EA. FERNOTRAC SPLINT ADLT&PED 441 2 1 C 475.00 - ---475.00 . 1 -- ARTIAL SHI MENT - WILL SHIP AND INVOICE WHEN AVAILA LE. ASE GOOD I EM, ,MAY BE SHIPPED SEPARATELY. 4 499-0652 EA PENLIGHT METALITE 8 8 2.25 18.00 2 5 499-7780 EA TOURNIQUET COMBAT APP. ORANGE 1 1 30.15 30.15 2 PRODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTIRER. OUR ORDER 6956057 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED 3EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS liHEN 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 PURCH SE YOU HAVE E ARNED A CREDI TOWARD BILL TO SHIP TO INVOICIEff INVOICE AMOUNT ITEM STATUS KEY RE�9 KEY 1308571 1308572 2449188-01 745 .15 H-Backordcred:Itemwmfollow SK-SchoolKit D-Discontinued:Item no longer available NC-No Charge H Z ORDER# ORDER DATE INVOICE DATE # OF BOXES P-Special Schein free Grinds M-Manufacturer will ship Item directly to you 0 6 9 5 6 0 5 7 01/31/13 1/31/13 3 P-Prescription Drug:Return Authorization Required R-Refrigerated Item:May be shipped separately CUSTOMER PO# PA E $-Special Schein Pricing U-Temporarily unavailable:please reorder MARK 1 OF 2 T-Taxable Item Continued on Next Page.......... HENRY SCHEIN 0 SHIP TO/SOLD TO: EMSCarmel Fire Dept Head Quarters MI 135 Duryea Road, Melville, NY 11747 INVOICE 2 Civic Sq Carmel,IN 46032-2584 010000130857102449188110010000000745 150131133 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 745.15 INVOICE# INVOICE DATE 2449188-01 1/31/13 CUSTOMER PO MARK Please detach here and mail the above with your payment HSI ORDER# ORDER DATE DUE DATE 06956057 01/31/13 03/02/13 D&B#:01-243-0880 WHSE DEA# RHO]62494 Fed ID: 1 1-31 36595 GOODS OR SERVICES, RECEIVABLE OR REDEEMABLE N ACCORDANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU 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, SUM VALUE MUST BE DISCLOSED AS A DI COUNT kGAINS7 THE PURCHASES THAT EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN THESE RECORDS. ---------- --------------------------------- ------ ----- ------------- ----- ---------- --------------------------------- ------ ----- ------------- ----- ortheast D stribution Center 1 WEAVER R AD DENVER, PA 17517 ---------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 745.15 Invoice Date + 30 days 745.15 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEI4 INC. DEPT,CH 10211 a ALATINE, I 60055-0241 BILL To SHIP To MOICE# INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 2449188-01 745.15 s-Hackordcred:Itemwill follow SK-SchoolKit D-Discontinued:Item no longer available NC-No Charge H I ORDER# ORDER DATE INVOICE DATE # OF BOXES F-Special Schein Free(foods M-Manufacturer will ship Item directly to you 06956057 01/31/13 1/31/13 3 1'-Prescription Drug:Return Authorization Required T MER P p E R-Refrigerated Item:May be shipped separately $-Special Schein Pricing U-Temporarily unavailable:please reorder MARK 2 OF 2 T-Taxable Item 9i HENRY SCHEIN° EMS SALE ......................................... ------------------------------------............................... ....... Payment Terms: 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,o 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 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 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 manufacturer warranties.Before opening handpieces or terms and conditions,please contact our International Department: equipment,we suggest that you check the shipping container 1-800-845-35 0 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. LP300 HSI ORDER# ORDER DATE DUE DATE 06956521 01/31/13 03/02/13 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 This order ias been processed by our MIDWEST D.C. 5315 WES 74TH 3TREET INDIANAP LIS,IN 46268 1 499-6737 EA NON-REBREATHER MASK ADULT 150 150 C 0.91 136.50 3 ASE GOOD I EM, MAY BE SHIPPED SEPARATELY. 2 496-6428 100/BX LANCET SURGILANCE GRAY 23G 1.8 2 2 10.00 20.00 4 3 555-1166 U EA PROTECTIV ACUVNC SFT CATH 18X1.25 100 100 2.23 223.00 4 4 555-5396 U EA PROTECTIV ACUVNC SFT CATH 20X1.25 100 100 2.23 223.00 4 --5.. 555-A687 U EA PROTECTIV ACUVNC SFT CATH 22GX1" - 50 50 2.23-' '111.50 4 6 499-5004 EA ET TUBE CUFFED 6.0 10 10 1.05 10.50 4 7 499-7629 EA ET TUBE CUFFED 7.0 20 20 1.05 21.00 4 8 499-9022 EA ET TUBE CUFFED 8.0 10 10 1.05 10.50 4 F YOU ARE DARTICIPATING IN A DISCOUNT PROGRAM (E.G. POINTS, GIFTS OR OTHER PECIAL AWA DS ("DISCOUNT")) , WITH THIS PURL SE YOU HAVE EARNED A CREDII, TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING OR WILL R CEIVE OTICE OF THE DISCOUNT VALUE. FROM TIME TO TIME, MED CARE, MEDICAID, TRI ARE OR OTHER PAYER MAY REQUEST INFORMATION REGARDING SUCH V LUE, D UPON ANY S CH REQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT GAINS THE PURCHASE THAT BILL TO SHIP TO INVOICE# INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1817102 2449722-01 756 .00 B-Backordered;Item will follow SK-School Kin D-Discontinued:Item no longer available NC-No Charge H I ORDER# ORDER DATE INVOICE JDATE # OF BOXES F-Special Schein Free Goods 31 13 1/31/13 t} M-Manufacturer will ship Item directly it)you 06956521 01 / / P-preuaption Drug:Return Authorization Required T MER PO# pA R-Refrigerated Item:May be shipped separately $-Special Schein Pricing MARK 013113 U-Temporarily unavailable:please reorder 1 OF 2 T-Taxable Item Continued on Next Page.......... HENRY SCHEIN F I E�� SHIP TO/SOLD TO: Carmel Fire Department MI 135 Duryea Road, Melville, NY 11747 INVOICE 540 W 136 St Station 46 Michael Kaufmann Carmel,IN 46032-8806 01000013085711024497221 10010000000756000131135 BILL To: Carmel Fire Dept MI 2 Civic Sq Carmel, IN 46032-7543 Carmel Fire Dept HILL TO SHIP TO INVOICE AMOUNT 2 Civic Sq Carmel, IN 46032-7543 1308571 1817102 756 .00 INVOICEff INVOICE DATE 2449722-01 1/31/13 CUSTOMER PO MARK 013113 please detach here and mail the above with your payment HSI ORDER ..ORDER DATE DUE..DATE 06956521 01/31/13 03/02/13 D&B#:01-243-0880 WHSE DEA# RHO162494 Fed ID: 11-3136595 EARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN TH SE RECORDS. ----------- --------------------------------- ------ ----- ------------- ------- ---------- --------------------------------- ------ ----- ------------- ------- MERCHANDI E TOTAL 756.00 nvoice Date + 30 days 756.00 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 INVOICE4 INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1817102 2449722-01 756. 00 It-liackordered:Itemwill follow SK-SchoolKit D-Discontinued:Item no longer available NC-No Charge H I RDER ORDER DATE INVOICE DATE F BOXES P-Special Schein Frec Goods M-Manufacturer will ship Item directly to you 06956521 0 1/3 1/13 1/31/13 4 p-prescription Drug:Return Authorization Required CUSTOMER PO# PAGE R-Retrieerated Item:May be shipped separately $-Special Schein pricing U-Temporarily unavailable:please reorder MARK 013113 2 OF 2 T-Taxable Item ......... ...._... .................... ......... ....... 91 HENRY SCHEIN" EMS ERMS SALE -------------------------- ----------- Payment Terms-, 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 manutacturers'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. 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 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 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 manufacturer warranties.Before opening handpieces or terms and conditions,please contact our International Department: equipment,we suggest that you check the shipping container 1-800-845-3550'800 845 3550 and packing list to verify that you have received exactly what Prescription Drug Returns Instructions: you wdered.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. LP300 HSI ORDER# ORDER DATE DUE DATE 06283228 01/08/13 02/23/13 D&B#:O 1-243-0880 WHSE DEA# RHO162494 Fed ID: 1 1-31 36595 a � r p6 0'i i R mom. 17-571-266 1 114-7554 EA DISPENSER GLOVE DOUBLE 4 4 30.75 123.00 RODUCT IS EING SHIPPED TO YOU DIRECTLY FROM THE MANUFACTURER. OUR ORDER 6283228 HAS BEEN SPLIT INTO MULTI LE SHI MENTS. CERTAIN ITEM WILL E SHIPPED EPARATELY. YOU WILL BE BILLED FOR THESE ITEMS HEN THEY ARE SHIPPED. F YOU ARE 3ARTICIPATING IN A DISCOUNT PROGRAM (E.G. POIN S, GIFTS OR OTHER PECIAL AWARDS ("DISCOUNT") ) , WITH THIS PURCHASE YOU HAVE EARNED A CREDI TOWARD GOODS OR S RVICES, RECEIVABLE OR REDEEMABLE N ACCO DANCE WITH DISCOUNT PROGRAM RULES. UP04 DISCOUNT RECEIPT OR REDEMPTION, OU ARE RECEI ING 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 SIJCH EQUEST, SU H VALUE MUST BE DISCLOSED AS A DI COUNT AGAINSrl THE PURCHASE THAT ARNED SUCH VALUE. ACCORDINGLY, YOU SHOULD RE AIN =SE RECORDS. MERCHANDI E TOTAL 123.00 Invoice Date + 30 days 123.00 LEASE NOTE NEW REMIT TO ADDRESS Please remi payments only to the following a dress: ENRY SCHEIJ INC. DEPT CH 10211 ALATINE, I 60055-0241 FILL TO SHIP INVOICElf INVOICE AMOUNT ITEM STATUS KEY REM KEY 1308571 1308572 2565983-01 123 .00 B-Backordered:Item will follow SK-SchoolKit D-Discontinued:Item no longer available NC-No Charge I ORDER# ORDER DATE INVOICE DATE # OF BOXES F-Special Schein Free Goods M-Manufacturer will ship Item directly to you 06283228 0 1/0 8/13 1/24/13 N-Prescription Drug:Return Authorization Required R-Refrigerated Item:May be shipped separately CUSTOMER PO4 PAGE# $-Special Schein Pricing MARK 1 OF 1 T-Taxable Temporarily unavailable:please reorder t-ay eni r errxrs: 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 ill YOUU 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 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 manufacturer warranties.Before opening handpieces or terms and conditions,please contact our International Department: equipment,we suggest that you check the shipping container 1-800-8455-3550 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. LP300 prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by mhom, 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)) 2449188-01 $745.15 2449722-01 $756.00 2565983-01 I I $123.00 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 NO. WARRANT NO. ALLOWED 20 Henry Schein IN SUM OF $ Dept Ch 10241 Palatine, IL 60055 $1,624.15 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#ITITLE AMOUNT Board Members 1120 2449188-01 102-390.11 $745.15 1 hereby certify that the attached invoice(s), or 1120 2449722-01 102-390.11 $756.00 bill(s) is (are) true and correct and that the 1120 ( 2565983-01 1 102-390.11 I $123.00 materials or services itemized thereon for which charge is made were ordered and received except Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund