320301 01/04/2018 4y u.Gggf`
.; CITY OF CARMEL, INDIANA VENDOR: 371443
ONE CIVIC SQUARE VIRGIN PULSE, INC. CHECK AMOUNT: $*****7,210.00*
CARMEL, INDIANA 46032 DEPARTMENT 3310 CHECK NUMBER: 320301
r PO BOX 123310 CHECK DATE: 01/04/18
DALLAS TX 75312-3310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 INV70800 3,625.00 OTHER EXPENSES
301 5023990 INV70897 3,585.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 371443 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VIRGIN PULSE, INC. IN SUM OF$ 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
$7,210.00
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
INV70800 50-239.90 $3,625.00 1 hereby certify that the attached invoice(s),or 11/30/17 INV70800 $3,625.00
301 301 Prior Year 301 301
INV70897 50-239.90 $3,585.00 bill(s)is(are)true and correct and that the 12/15/17 INV70897 $3,585.00
301 1 1 301 1 Prior Year materials or services itemized thereon for 301 301
which charge is made were ordered and
received except
Wednesday,January 03,2018
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
Virgin Pulse
I - 492 Old Connecticut Path Invoice
Ste 601
F-=-- - Framingham MA 01701 #I NV70897
United States
12/15/2017
Activity Month: Dec 2017
Sponsor PO# Memo Terms
Email invoicingOlvirginpulse.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
-: - F. -
j
Item Quantity " `Rate Amount
Rewards Earned 1 $3,585.00 $3,585.00
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $3,585.00
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 I Total $3,585 00 )
Bank Address:Santa Clara,CA 95054
Payments/Credits $0.00
Amount Due $3,585.00
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.
a - -
JAN 0 3 2018
CIark E reavurer
1 of 1
Virgin Pulse
492 Old Connecticut Path Invoice Ste 601
- �• Framingham MA 01701 #I NV70800
United States
11/30/2017
Activity Month:Nov 2017
Sponsor PO# Memo Terms
Email invoicing(cDvirginpulse com City of Carmel NET 30
Bili 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
-Quantity
t;Item ; Rate
Amounf
y
r
t �
Rewards Earned 1_�-__ $3,625.00 $3,625.00-e
Bank ACH Payment Instructions: Please Remit Checks To: Subtotal $3,625.00
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 75312-3310r —
-- - — -
Bank Name:Silicon Valley Bank m Total ,,. $3 625.00
Bank Address:Santa Clara, CA 95054
L._
Payments/Credits $0.00
Amount Due $3,625.00
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-'¢ ed To,
JAN 0 3 2018
1 of 1