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HomeMy WebLinkAbout305532 11/28/16 CITY OF CARMEL, INDIANA VENDOR: 369258 ONE CIVIC SQUARE DLH COUNSELING &CONSULTING CHECK AMOUNT: $*"****"350.00" CARMEL, INDIANA 46032 11925 E 65TH ST,SUITE 4 CHECK NUMBER: 305532 INDIANAPOLIS IN 46236 CHECK DATE: 11/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 111716.CPD 350.00 MEDICAL EXAM FEES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) DLH COUNSELING &CONSULTING ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 11925 E 65TH ST, SUITE 4 IN SUM OF$ 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 111716.CarmelPD 43-407.01 $350.00 1 hereby certify that the attached invoice(s),or 11/17/16 111716.CarmelPD Psych Exam for C.Kim $350.00 1110 101 1110 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except FFdda�y, November 18,2016 Tim Green Chief of Police I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer DLH Counseling and Consulting,LLC. Darren L. Higginbotham,Psy.D. 11925 E. 65 ' Street, Suite 4 Indianapolis, IN 46236 Phone/Fax: (317) 643-9901 dlhcounseling(a),Qm� ail corn Tax ID: 45=4501051 Invoice#: 111716.CARMELPD Re: One (1) pre-employment:psychological evaluation;Noo.ember 201$ Date of Service: Description of Service: Char e: November.9;2016 Psychological evaluation (Christopher Kim;.police officer) . $350:00 Amount due $350.00 Please remit,payment to the address above. Thank you for your.business: