318271 11/07/2017 CITY OF CARMEL, INDIANA VENDOR: 369258
(� ONE CIVIC SQUARE DLH COUNSELING & CONSULTING CHECK AMOUNT: $ 600.00"
�4 CARMEL, INDIANA 46032 11925
65THPOLIS ST,SUITE 4 CHECK NUMBER: 318271
INDIMiror �.
CHECK DATE: 11/07/17
` DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340703 101617CARMPD 600.00 MENTAL HEALTH COUNSEL
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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
dlhcounselingggmail.com
Tax ID: 45-4501051
Invoice #: 101617.CARMPD
Re: One (1) psychological fitness for duty evaluation (T.L.), October, 2017.
Description of Service: Charge:
Pre-evaluation consult with employer: No charge
Review employer referral documents: $150
Psychological testing: $150
Interview with employee: $150
Report writing: $150
Post-evaluation consult with employer No charge
Amount due: $600.00
Please remit payment to the address above. Thank you for your business.