HomeMy WebLinkAbout308090 02/13/17 (9,
CITY OF CARMEL, INDIANA VENDOR: 369258
ONE CIVIC SQUARE DLH COUNSELING &CONSULTING CHECK AMOUNT: $*******900.00*
CARMEL, INDIANA 46032 11925 E 65TH ST,SUITE 4 CHECK NUMBER: 308090
INDIANAPOLIS IN 46236 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 900.00 MEDICAL EXAM FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 369258 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
DLH COUNSELING &CONSULTING IN SUM OF$ CITY OF CARMEL
11925 E 65TH ST, SUITE 4 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
INDIANAPOLIS, IN 46236
Payee
$900.00
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
0 43-407.01 $900.00 1 hereby certify that the attached invoice(s),or 2/6/17 0 negotiator evaluations-Smiley,Tilson $900.00
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, February 07,2017
Green,Tim
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 'Street,'Suite 4
Indianapolis, IN 46236
Phone/Fax: (317).64M901
dlhcounsehnagrriail.corn
Tax ID:45=4501051
Invoice#: 020617.CARMELPD-
Re: Two (2) special assignmentpsychologicarevaluations;January 18, 2017.
Date of Service: Description of Service: : Charge:
January 18;2017 (Landry Smiley;Negotiator)
Clinical interview
Psychological testing.
Reportwriting
3 hours @$150/hr: : $450.00
anua 18' 2017,. (Travis Tilson;Negotiator)
J . '
Clinical interview
Psychological Testing
Report writing
3.hours@$150/hr $450.00
Amount due: $900.00
Please remit payment to the address above. Thank you foryour business:. .