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: