318888 11/21/2017 CITY OF CARMEL, INDIANA VENDOR: 371443
ONE CIVIC SQUARE VIRGIN PULSE, INC. CHECK AMOUNT: $"""'"4,450.00`
4 � CARMEL, INDIANA 46032 DEPARTMENT 3310 CHECK NUMBER: 318888
PO BOX 123310 CHECK DATE: 11/21/17
DALLAS TX 75312-3310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 INV69713 1,930.00 OTHER EXPENSES
301 5023990 INV70143 2,490.00 OTHER EXPENSES
301 5023990 INV70271 30.00 OTHER EXPENSES
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Virgin Pulse
492 Old Connecticut Path
Invoice
71", //�/� Ste 601
Framingham MA 01701 #INV69713
United States 10/31/2017
Activity Month:Oct 2017
Sponsor PO# Memo Terms
Email invoicina(cDvirginpulse.com City of Carmel NET 30
Bill To Ship To
City of Carmel City of Carmel
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States
4uantity i =State
Rewards Earned 1 $1,870.00
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $1,870.00
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310 Tax Total $0.00
ABA Number:121140399 PO Box 123310
SWIFT:SVBKUS6S Dallas,TX 75312-3310
Bank Name:Silicon Valley Bank Tattai ri1;
Bank Address:Santa Clara,CA 95054
Payments/Credits $0.00
Amount Due $1,870.00
For any invoice past due beyond payment terms a finance charge of 1.5%per month or
18%per year may be added to the invoice.
S�ubrpk=::ted To
NOV 21 2017
CIaerk T eaSsurer
1 of 1
Virgin Pulse
492 Old Connecticut Path Invoice
Ste 601
Framingham MA 01701 #I NV69513
United States 10/31/2017
Activity Month:Oct 2017
Sponsor PO# Memo Terms
Email invoicingPa virginpulse.com City of Carmel NET 30
Bill To Ship To
City of Carmel City of Carmel
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States
` ;rF1 : QU8rltity Rdt6 ��i�i!urtt"`
Subsidized Online FitBit, MisFit, or Polar units shipped in 1 $60.00
October 2017
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $60.00
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310 Tax Total $0.00
ABA Number:121140399 PO Box 123310
SWIFT:SVBKUS6S Dallas,TX 75312-3310
Bank Name:Silicon Valley Bank Tatet60
=(0,
Bank Address:Santa Clara,CA 95054 v .,
Payments/Credits $0.00
Amount Due $60.00
For any invoice past due beyond payment terms a finance charge of 1.5%per month or
18%per year may be added to the invoice.
NOV 21 2017
Clerk T'r asurer
1 of 1
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 - ACCOUNTS PAYABLE VOUCHER
Vendor# 371443
VIRGIN PULSE, INC. IN SUM OF$ CITY OF CARMEL
DEPARTMENT 3310 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
PO BOX 123310 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
DALLAS,TX 75312-3310
Payee
$2,490.00
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
301 Medical Fund Date Due_
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
INV70143 50-239.90 $2,490.00 I hereby certify that the attached invoice(s),or 11/15/17 INV70143 $2,490.00
301 301 301 301
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
th
Monday, November 27,2017
Lamb, Barbara
Director
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
,20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
vendor# 371443 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VIRGIN PULSE, INC. IN SUM OF$ CITY OF CARMEL-
DEPARTMENT 3310 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
PO BOX 123310 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
DALLAS,TX 75312-3310
_._ Payee
$30.00 _
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
301 Medical Fund _ Terms
301 Medical Fund Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
INV70271 50-239.90 $30.00 I hereby certify that the attached invoice(s),or 11/1/17 INV70271 $30.00
301 301 301 301
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, November 27,2017
Lamb, Barbara
Director
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
r
Virgin Pulse
492 Old Connecticut Path
Invoice
Ste 601
r LT G Framingham MA 01701 #)NV70 1 43
United States 11/15/2017
Activity Month:Nov 2017
Sponsor PO# Memo Terms
Email invoicing(cDvirginl2ulse.com City of Carmel NET 30
BilI To ShipTo
City of Carmel City of Carmel
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States
ON
, x
an
Rewards Earned 1 $2,490.00
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $2,490.00
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310 Tax Total $0.00
ABA Number: 121140399 PO Box 123310
SWIFT:SVBKUS6S Dallas,TX 75312-3310
Bank Name:Silicon Valley Bank .; � rl0 00'
Bank Address:Santa Clara, CA 95054
Payments/Credits $0.00
Amount Due $2,490.00
For any invoice past due beyond payment terms a finance charge of 1.5%per month or
18%per year may be added to the invoice.
Subs'll"Ied To
NOV 21 2017
De.r *11 ,. S
1 of 1
Virgin Pulse ■
# r Invoice
Virgin
492 Old Connecticut Path
yrsSte 601
Framingham MA 01701 #INV70143
United States 11/15/2017
Activity Month:Nov 2017
Sponsor PO# Memo Terms
Email invoicing(a virginpulse.com City of Carmel NET 30
Bill To Ship To
City of Carmel City of Carmel
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States g�
SCS%.. �e....�v r...ff... ..� d ., .. .. . ... ...
Rewards Earned 1 $2,490.00
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $2,490.00
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310 Tax Total $0.00
ABA Number:121140399 PO Box 123310
SWIFT:SVBKUS6S Dallas,TX 75312-3310 wkn'k
Bank Name:Silicon Valley Bank
Bank Address:Santa Clara,CA 95054
Payments/Credits $0.00
Amount Due $2,490.00
For any invoice past due beyond payment terms a finance charge of 1.5%per month or
18%per year may be added to the invoice.
Submitted To
NOV 21 2017
Clerk Treasurer
1 of 1
Virgin Pulse
x 492 Old Connecticut Path Invoice
Ste 601
�- Framingham MA 01701 #I NV7027
United States 11/1/2017
Activity Month:Nov 2017
Sponsor PO# Memo Terms
Email invoicing(cDvirginpulse.com City of Carmel True Up Invoice NET 30
BiIITo Ship To
City of Carmel City of Carmel
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States
P � Quantity Rate:,",'. '►)wlDutlt
e,e .
Annual Program Subscription Fee billing 2 $15.00 $30.00
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $30.00
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310 Tax Total $0.00
ABA Number:121140399 PO Box 123310
SWIFT:SVBKUS6S Dallas,TX 75312-3310
Bank Name:Silicon Valley Bankes
Bank Address:Santa Clara, CA 95054 _'
Payments/Credits $0.00
Amount Due $30.00
For any invoice past due beyond payment terms a finance charge of 1.5%per month or
18%per year may be added to the invoice.
NOV 21 2017
1 of 1