162474 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 361684 Page 1 of 1
0 ONE CIVIC SQUARE PROFESSIONAL PSYCHOLOGICAL SERN&K AMOUNT: $300.00
CARMEL, INDIANA 46032 PO BOX 90409
INDIANAPOLIS IN 46290 CHECK NUMBER: 162474
CHECK DATE: 817/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4340703 300.00 MENTAL HEALTH COUNSEL
r
PROFESSIONAL, PSYCHOLOGICAL, SERVICES
10293 North Meridian Street, Suite 375
P. O. Box 90409
Indianapolis, Indiana 46290 -0409
PHONE: (317) 581 -2288
FAX: (317) 581 -2295
Steven .I. Couvillion, Ph.D., ABPdN Jonni L. Gonso, Ph.D.
Patricia M. Couvillion, Ph.D. Keith Magnus Ph.D.
H. Jeffrey Davis, Ph D. Melody N. Dilk, Ph.D., J.D. Peter Dodzik, Psy.D,ABPdN
Donald P. Hay, M.D., D.F.A.P.A.
Corby A. Bubp, Ph.D.
July 23, 2008
Carmel Fire Department
Attn: Jan Hope
2 Civic Square
Carmel, IN 46032
Re: Billing for Heather Drinkwater Firefighter recruit
Ms. Hope,
The following is a billing summary for services rendered for Psychological Evaluation
for Heather Drinkwater:
7/23/08 Interview, Records Review, Testing, Scoring Report Writing $300
If you have any questions about this matter, please do not hesitate to contact me.
Sincerely,
Corby A. Bubp, Ph.D., HSPP
Consulting Psychologist
CAB sb
PPS invoice 1020
VOUCHER NO. WARRANT NO.
Professional Psychological Services ALLOWED 20
10293 North Meridian Street, Ste. 375 IN SUM OF
P.O. Box 90409
.Indianapolis, IN 46290
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 43- 407.03 $300.00 1 hereby certify that the attached invoice(s), or
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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1955)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/23/08 Recruit Psych. Testing $300.00
1 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
Clerk- Treasurer