HomeMy WebLinkAbout333417 12/14/18 ®� CITY OF CARMEL, INDIANA VENDOR: 371443
ONE CIVIC SQUARE VIRGIN PULSE, INC. CHECK AMOUNT: $*****5,250.96*
a� CARMEL, INDIANA 46032 DEPARTMENT 3310 CHECK NUMBER: 333417
v «oN PO BOX 123310 CHECK DATE: 12/14/18
DALLAS TX 75312-3310
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 INV87098 5,250.96 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Hoard of Accounts City Form No.201(Rev.1995)
Vendor# 371443 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VIRGIN PULSE, INC. IN SUM OF$ 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
$5,250.96
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
301 Medical Fund Date Due
PO# ACCT# r DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
INV87098 50-239.90 $5,250.96 I hereby certify that the attached invoice(s),or 12/11/18 INV87098 $5,250.96
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, December 12,2018
CA4--d
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\
, , 75 Fountain Street s� Invoice
��y Providence RI 02902
Cs united states #I NV87098
11/30/2018
Email invoicing@virginpulse.com Sponsor PO# Memo Terms
City of Carmel NET 30
BIIITo Ship To Activity Month
City of Carmel United States Nov 2018
Carmel City Hall
One Civic Square
Carmel IN 46032
United States
hero ' Quantity's Rate rAmounts
Rewards Earned 11/16/2018-11/30/2018 1 $5,200.00 $5,200.00
Subsidized devices shipped in November 2018 1 $50.96
Bank USD ACH Payment Instructions: Please Remit Checks To: Subtotal $5,250.96
Account Name:Virgin Pulse Inc. Virgin Pulse, Inc
Account Number:3300940047 Dept 3310
ABA Number: 121140399 PO Box 123310 Tax Total $0.00
SWIFT:SVBKUS6S Dallas,TX 75312-3310
Bank Name:Silicon Valley Bank
Bank Address:3003 Tasman Drive, Total '$5 25£0 96
Santa Clara, CA 95054
Please inquire for other currency Payments/Credits $0.00
remittance instructions Amount Due $5,250.96
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.
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