302565 08/31/16 CITY OF CARMEL, INDIANA VENDOR: 369258
ONE CIVIC SQUARE DLH COUNSELING & CONSULTING CHECK AMOUNT: $*******350.00*
:. CARMEL, INDIANA 46032 11925 E 65TH ST,SUITE 4 CHECK NUMBER: 302565
INDIANAPOLIS IN 46236 CHECK DATE: 08131/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4341999 081616CARMEL 350.00 OTHER PROFESSIONAL FE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
DLH COUNSELING &CONSULTING ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
11925 E 65TH ST, SUITE 4 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46236 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$350.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
081616.CarmelPD 43-419.99 $350.00 1 hereby certify that the attached invoice(s),or 8/16/16 081616.CarmelPD pre employement testing-Valentine $350.00
1110 101 1110 101
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
Tuesday,August 23,2016
' J r
Tim Green
Chief of Police
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
DLH Counseling and Consulting,LLC.,
Darren L. Higginbotham,Psy.D:
11925 E. 65`h Street,Suite 4
Indianapolis, IN 46236
Phone/Fax: (317) 643-9901
dlhcounsehng@=ail.com
Tax ID: 45-4501051
Invoice #:.081.616:CARMELPD
Re: One (1) pre-employment:psychological evaluation;August 2016
Date of Service: Description of Service: Charge:
August 11, 2016 o 'PsY �cholcal evaluation
(Patrick Valentine;police officer) $350.00
Amount due: $350.00
Please remit.payment to the address above.'Thankyou for your.business.