HomeMy WebLinkAbout330259 09/21/18 CITY OF CARMEL, INDIANA VENDOR: 371443
/ ONE CIVIC SQUARE VIRGIN PULSE, INC. CHECK AMOUNT: $*****4,685.00*
f. CARMEL, INDIANA 46032 DEPARTMENT 3310 CHECK NUMBER: 330259
PO BOX 123310 CHECK DATE: 09/21/18
DALLAS TX 75312.3310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 INV83055 4,685.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 371443 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VIRGIN PULSE, INC. IN SUM OF$ 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
$4,685.00
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
INV83055 50-239.90 $4,685.00 I hereby certify that the attached invoice(s),or 9/15/18 INV83055 Rewards Earned 9/1/18-9/15/18 $4,685.00
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
Wednesday,September 19,2018
Crider,James
Administration
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 Invoice
75 Fountain Street
/t t Providence RI 02902
Imo, /
United States #INV83055
9/15/2018
Customer Balance$9,510.00
Email invoicing�a virginpulse.com Sponsor PO# Memo Terms
City of Carmel PO NET 30
Bill To Ship To Activity Month
City of Carmel City of Carmel Sep 2018
Carmel City Hall Carmel City Hall
One Civic Square One Civic Square
Carmel IN 46032 Carmel IN 46032
United States United States
a - �77 77
71,17P 771-7-
Item s Quantity Rate Amount`?
Rewards Earned 9/1/2018-9/15/2018 1 $4,685.00 $4,685.00
Bank USD ACH Payment Instructions: Please Remit Checks To: Subtotal $4,685.00
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 77,
Bank Address:3003 Tasman Drive, Total"
$4 68500:;
Santa Clara, CA 95054
Please inquire for other currency Payments/Credits $0.00
remittance instructions Amount Due $4,685.00
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.
Submifted To
SEP 19 2018
C-Ierk, Treasurer
lof 1