2025-12 GB Instruments Serviced.pdf
PDF 115 KB Posted
- Solicitation number
- 36C25226Q0075
About this file
This is a packing slip from STERIS Instrument Management Services, Inc. documenting the return of repaired dental and surgical instruments to the Milo C Huempfner VA Medical Center in Green Bay, Wisconsin. The shipment, dated December 19, 2025, covers 20 line items representing various instrument kits and individual instruments that have undergone on-location repair and maintenance services. The order number is 4326841 with service request number V7W751966. All items are priced at $0.00, with the subtotal listed as $0.00, indicating this is a warranty or contracted service arrangement rather than a transactional purchase.
The repaired instruments include dental hygiene kits, restorative kits, clinic basic kits, perio basic sets, a cataract tray, and a vasectomy kit, along with a repair bin containing miscellaneous items. Services performed on individual instruments vary by level, ranging from Level 1 (basic inspection, cleaning, rinsing, and drying) to Level 3 (comprehensive services including sharpening, alignment, adjustment, and deburring). Specific instruments repaired include forceps, scalers, probes, scissors, elevators, clamps, retractors, osteotomes, and micro-surgical instruments. The document notes that customers should not pay based on this packing slip as an invoice will follow, and it includes a disclaimer regarding any recalled items, stating that STERIS did not take recall-related actions during the repair process.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2025-11 GB Instruments Serviced.pdf | ||
| VAAR 852.219-75-Certification Page.docx | DOCX document | |
| 2026-02-02 MIL Instruments Serviced.pdf | ||
| C03 Attachment 1 - Instrument List 1.xlsx | XLSX spreadsheet | |
| 2025-10 GB Instruments Serviced.pdf | ||
| S06-36C25226Q0075 0001.docx | DOCX document | |
| S05-VENDOR QUESTIONS-ANSWERS.docx | DOCX document | |
| 2026-02-09 MIL Instruments Serviced.pdf | ||
| 2026-02-17 MIL Instruments Serviced.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Packing Slip Order Number: 4326841 Service Request Number: V7W751966
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 12/19/2025 Page 1 of 5
Customer
MILO C HUEMPFNER VA MEDICAL CENTER- GEEEN BAY
2851 UNIVERSITY AVENUE
Green Bay, WI 54311
Deliver To
Purchase Order Department Operating Room
Last Ship Date
19-DEC-2025
Reference
Sales Person Justice, Jared Michael
Customer Contact Rodney Champeau
Contact Phone Number 920-431-2613
Customer Number 65906
Special Instructions
Notes :
Line Description Qty Unit Price Ext Price
1 SN:C10000036 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 1) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
10 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
2 SN:10269 ON-LOCATION INSTRUMENT SERVICE (GB Dental Perio Osteotome Set 2)
1 $0.00 $0.00
ONL2562 - Mallet: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Deburr 1 $0.00 $0.00 ONL2582 - Osteotomes: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen 16 $0.00 $0.00
Item Total USD $0.00
3 SN:C10000600 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL
RESTORATIVE KIT 17)
1 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
1 $0.00 $0.00
ONL1203 - Delicate (Tenotomy/Iris) Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Deburr, Align, Proximate Tips, Adjust Shank
1 $0.00 $0.00
ONL2352 - Elevators-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen
11 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL2383 - Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL3101 - Needleholder: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2732 - Retractors-Handheld: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
1 $0.00 $0.00
ONL2781 - Retractors-Self Retaining: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
4 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 7 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 4 $0.00 $0.00
Item Total USD $0.00
4 SN:C10000414 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL CLINIC BASIC
KIT 7)
1 $0.00 $0.00
Service Request Number: V7W751966
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 12/19/2025 Page 2 of 5
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL1102 - General Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
5 SN:C10000489 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL CLINIC BASIC
KIT 16)
1 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
2 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL2383 - Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL1102 - General Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
6 SN:C10000039 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 4) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
Item Total USD $0.00
7 SN:C10004296 ON-LOCATION INSTRUMENT SERVICE (GB Dental Perio Basic Set 14)
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL1403 - Supersharp Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Adjust Shank
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
Item Total USD $0.00
8 SN:C10000037 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 2) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
Item Total USD $0.00
Service Request Number: V7W751966
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 12/19/2025 Page 3 of 5
9 SN:C10001678 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 48) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
Item Total USD $0.00
10 SN:C10000064 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 29) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
11 SN:C10000416 ON-LOCATION INSTRUMENT SERVICE (GB OR CATARACT TRAY
7)
1 $0.00 $0.00
ONL1203 - Delicate (Tenotomy/Iris) Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Deburr, Align, Proximate Tips, Adjust Shank
1 $0.00 $0.00
ONL4301 - Micro Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
5 $0.00 $0.00
ONL4303 - Micro Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust, Straighten, Align Tips
4 $0.00 $0.00
ONL4103 - Micro Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
2 $0.00 $0.00
ONL2371 - Manipulator-Ophthalmic: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
3 $0.00 $0.00
ONL2372 - Manipulator-Ophthalmic: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align
1 $0.00 $0.00
Item Total USD $0.00
12 SN:C10000482 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL
RESTORATIVE KIT 10)
1 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
1 $0.00 $0.00
ONL2352 - Elevators-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen
11 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL2383 - Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2732 - Retractors-Handheld: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
1 $0.00 $0.00
ONL2781 - Retractors-Self Retaining: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
4 $0.00 $0.00
ONL1403 - Supersharp Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Adjust Shank
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 8 $0.00 $0.00
Service Request Number: V7W751966
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 12/19/2025 Page 4 of 5
ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 3 $0.00 $0.00
Item Total USD $0.00
13 SN:C10000059 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 24) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
14 SN:C10000127 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL CLINIC BASIC
KIT 1)
1 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL1102 - General Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
15 SN:9999 (Repair Bin) 1 $0.00 $0.00
ONL2353 - Elevators-D/E: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen, Reshape Edge
1 $0.00 $0.00
ONL2412 - Forceps-Bone Cutting S/A: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen Edge
4 $0.00 $0.00
ONL2792 - Rongeurs-S/A: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Reset, Sharpen Edges
1 $0.00 $0.00
ONL2913 - Suction Tubes/Tips: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Straighten, Deburr, Round Tip
1 $0.00 $0.00
ONL8802 - Misc Repair: Level 2 Removed labels from trays 10 $0.00 $0.00
Item Total USD $0.00
16 SN:C10000523 ON-LOCATION INSTRUMENT SERVICE (GB DENTAL CLINIC BASIC
KIT 22)
1 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL1102 - General Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
17 SN:C10000522 ON-LOCATION INSTRUMENT SERVICE (GB Dental Perio Basic Kit 4) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL1403 - Supersharp Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Adjust Shank
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, 2 $0.00 $0.00
Service Request Number: V7W751966
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 12/19/2025 Page 5 of 5
Align, Remove Burrs ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
18 SN:C10000494 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 33) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
Item Total USD $0.00
19 SN:10268 ON-LOCATION INSTRUMENT SERVICE (GB GU Clinic Vasectomy 005) 1 $0.00 $0.00 ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 4 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
2 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL3101 - Needleholder: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL1302 - TC Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
2 $0.00 $0.00
Item Total USD $0.00
20 SN:C10011501 ON-LOCATION INSTRUMENT SERVICE (GB Dental Hygiene Kit 51) 1 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2203 - Scaler-Dental: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs
12 $0.00 $0.00
ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
Item Total USD $0.00
Customers: Do not pay from this document, invoice will follow.
Where applicable, tax and shipping/handling will be added.
******************************************************************** Subtotal USD $0.00
Customer Signature
We appreciate your business!
In the event any item(s) identified on this Packing Slip is currently subject to a recall, please be aware that in the process of completing the repairs indicated, IMS did not take actions related to any such recall. We encourage you to strictly follow any guidance provided by the Recalling Firm with respect to any recall in effect.
File details come from the government source that posted it. Updated .