5-Exhibt H Sample Reporting.xlsx

XLSX spreadsheet 44 KB Posted Dec 15, 2025

Attached to: ADA Digital Accessibility – WCAG 2. 1 AA / 2. 2 AA Compliance Services – Consulting and Design
Solicitation number: AFI-2025-118
Issued by: Indiana

About this file

Written by GovTribe AI · Dec 16, 2025

This is an invoice data sample format document provided by ABC Company as Exhibit H to demonstrate the approved reporting structure for a state and local contract opportunity related to ADA Digital Accessibility and Compliance Services Consulting and Design in Indiana under the Alliance for Innovation (AFI) as the lead contracting agency. The document establishes standardized data fields and formats for invoice reporting that contractors must use when submitting billing documentation to the City of Industry and other AFI member municipalities. The sample invoice, dated April 12, 2022, demonstrates the required reporting structure across 19 line items encompassing various product categories including grocery and canned goods, supplies, equipment, textiles, pastry products, electronics, cooking oil, produce, product dispensers, shipping supplies, jam and jelly products, and tomato products distributed to multiple city departments including the Department of Public Works, Fire Department, Administration, and Senior Program.

The approved file formats for invoice submission include CSV, XLS, XLSX, fixed-width text, and EDI 810 formats. The invoice template requires detailed tracking of distributor and customer information, product specifications including manufacturer and distributor product codes, Global Trade Item Numbers (GTINs), pack sizes, units of measure, quantities, weights, unit pricing, extended pricing calculations, sales tax amounts, and optional purchase order numbers. The sample invoice totals $1,043.86 in extended pricing across all line items, demonstrating the comprehensive data capture required for tracking expenditures across multiple departments and product categories within the procurement program structure.

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Other files

File	Type	Posted
7-Appendix A Draft Contract and Offer and Contract Signature Form 118.docx	DOCX document	Dec 15, 2025
8-AFI RFP 2025118 Web Accessibility Consulting Final 12.15.25.docx	DOCX document	Dec 15, 2025
4-Appendix G NJ Disclosures.docx	DOCX document	Dec 15, 2025
1-Appendix B Terms and Conditions Acceptance Form.docx	DOCX document	Dec 15, 2025
3-Appendix D Supplier Administration Agreement - AFI Lead Agency.docx	DOCX document	Dec 15, 2025
2-Appendix C Federal Disclosures.docx	DOCX document	Dec 15, 2025
6-Tab 8 AFI Standard Terms and Condtions.docx	DOCX document	Dec 15, 2025

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Invoice Data Sample Format Approved file types: csv, xls, xlsx, fixed-width txt, EDI 810 Company: ABC Company Exhibit H

LEAD AGENCY

tc={0CBA013E-E1DD-482F-8BCA-FA1A792D0B95}: [Threaded comment]

Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924

Comment:

Distributor Location, the distribution center the invoice was filled out of Customer Name CUST LOCATION/Department tc={28BBFAC5-A21E-40AE-B800-058B319EADD7}: [Threaded comment]

Comment:

Customer Location, the name of the customer location correlating with the Customer Account Number CUST ADDRESS tc={DCF92266-AECC-4A6F-B073-95D7C4FF38F0}: [Threaded comment]

Comment:

Customer Address, the address correlating with the Customer Location CUST CITY tc={623295EE-7A3F-4F10-B4D1-B4D514AA0B80}: [Threaded comment]

Comment:

Customer City, the city correlating with the Customer Location CUST STATE tc={172529CB-8365-447D-97A7-7189C967C7C5}: [Threaded comment]

Comment:

Customer State, the state correlating with the Customer Location CUST ZIP tc={06C42126-FAF1-4260-92F0-15079A074619}: [Threaded comment]

Comment:

Customer Zip Code, the zip code correlating with the Customer Location CUST ACCOUNT # tc={19132E62-49B4-4FCC-93B9-4A7D7DAEC4CB}: [Threaded comment]

Comment:

Customer Account Number, the code or number the distributor uses to identify a customer account ship-to INV # tc={74E219E3-B727-4F42-A685-A21C204F34E8}: [Threaded comment]

Comment:

Invoice Number, the number assigned to the invoice INV DATE tc={D72F86FD-D5A4-451E-AFFB-9897F3BC340A}: [Threaded comment]

Comment:

Invoice Date, the date the invoice was filled ITEM DESC tc={C7C9681A-CA99-408E-83FE-E7508DFEFC6F}: [Threaded comment]

Comment:

Item Description or Product Description, describes what the prouduct is BRAND tc={F3096A02-36E6-4001-B89F-F1FF0607DDE0}: [Threaded comment]

Comment:

Brand, the brand of the product DIST PROD # tc={A0537584-0D51-4609-AE30-A43A98605F11}: [Threaded comment]

Comment:

Distributor Product Code (DPC) or Distributor Product Number, the code a distributor has assigned to a product MANUFACTURER NAME tc={600D4326-B443-4ECF-B0C6-F6B35936C1FE}: [Threaded comment]

Comment:

Manufacturer Name, the name of the manufacturer of the product MANUFACTURER PROD # tc={A3DA67C2-5411-47E8-A1C0-1BAC10A78E1D}: [Threaded comment]

Comment:

Manufacturer Product Code (MPC) or Manufactuer Product Number, the product number the manufacturer has assigned to the product GTIN tc={2515A391-CFC5-4D0D-AA88-1F7C5DF6FA80}: [Threaded comment]

Comment:

A Global Trade Item Number (GTIN) is a 12-digit, unique identifier for a product. PRODUCT CATEGORY tc={110F4E9D-985E-42FD-8AE2-6D9AED5CBF7E}: [Threaded comment]

Comment:

*Optional Product Category, the category the product sold is in PACK SIZE tc={C999A573-F999-4B38-B9B8-05B755F5AAC2}: [Threaded comment]

Comment:

Pack Size, the amount of the product in each unit UOM tc={2EA6DFB5-970B-4B79-A72F-1E993C9E3D9D}: [Threaded comment]

Comment:

The Unit of Measure the product is sold by QTY tc={EAB48CA1-1217-43AB-B84A-60DC6040B789}: [Threaded comment]

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Quantity, how many units of the product was sold WEIGHT tc={7E4C249A-3868-4510-9D30-27A7613A85FD}: [Threaded comment]

Comment:

Weight, if item sold by weight WEIGHT INDICATOR tc={5D5AE200-897C-4446-9115-5DA32D72B999}: [Threaded comment]

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Weight Indicator, Y/N indicating if product is sold by weight UNIT PRICE tc={52D75AC8-7267-4759-86ED-6B5091D0F171}: [Threaded comment]

Comment:

Unit Price, price per unit sold EXTENDED PRICE tc={17A077CF-E3E5-434E-872D-12DD56DDBCA9}: [Threaded comment]

Comment:

Extended price, unit price multipled by the quantity purchased SALES TAX tc={120CBE4F-EBD2-4993-A3B1-2FC536BAA5A7}: [Threaded comment]

Comment:

Sales tax PO # tc={066044CE-D8F7-412E-B163-E471BBBAAC79}: [Threaded comment]

Comment:

*Optional Purchase Order Number

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 1

BRAND1

ITEM12345

MANUFACT CORP

MANU9527459

123456789123

GROCERY CANNED AND DRY PRODUCTS

6/40 OZ

20.34

14567458

Alliance for Innovation

City of Industry

Fire Department

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 2

BRAND1

ITEM12346

MANUFACT CORP

DIS7365493

123456789876

SUPPLIES NON FOOD AND EQUIPMENT

6/CS

38.45

76.9

14567458

Alliance for Innovation

City of Industry

Administration

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 3

BRAND4

ITEM12347

MANUFACT CORP

FIH345S99

123456789123

TOMATO PRODUCTS SHELF STABLE

12 EA/CS

17.32

34.64

14567458

Alliance for Innovation

City of Industry

Senior Program

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 4

BRAND2

ITEM12348

MANUFACT CORP

200PC

123456789123

DESSERT PRODUCTS FROZEN

36/CS

31.33

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 5

BRAND5

ITEM12349

MANUFACT CORP

N095

123456789123

CEREAL PRODUCTS

2/3 LB

40.21

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 6

BRAND3

ITEM12350

MANUFACT CORP

RDG905X

123456789123

GROCERY CANNED AND DRY PRODUCTS

2/10 OZ

52.81

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 7

BRAND5

ITEM12351

MANUFACT CORP

124756

123456789123

LINEN AND TEXTILES

6 EA/CS

8.16

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 8

BRAND6

ITEM12352

MANUFACT CORP

C9611

123456789123

PASTRY PRODUCTS

10/CS

59.19

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 9

BRAND2

ITEM12353

MANUFACT CORP

BRGWH835969

123456789123

EQUIPMENT

36/CS

53.91

107.82

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 10

BRAND1

ITEM12354

MANUFACT CORP

4849BRN

123456789123

SUPPLIES NON FOOD AND EQUIPMENT

150/CS

28.16

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 11

BRAND3

ITEM12355

MANUFACT CORP

DSHJN

123456789123

ELECTRONIC AND ACCESSORIES

10/CS

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 12

BRAND3

ITEM12356

MANUFACT CORP

TJGFGN

123456789123

OIL COOKING

12 EA/CS

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 13

BRAND1

ITEM12357

MANUFACT CORP

235DFHHH

123456789123

PRODUCE

24/CS

20.34

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 14

BRAND6

ITEM12358

MANUFACT CORP

REFF134

123456789123

GROCERY CANNED AND DRY PRODUCTS

5/2.2 OZ

20.33

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 15

BRAND5

ITEM12359

MANUFACT CORP

AHSSCLR

123456789123

PRODUCT DISPENSERS AND ACCESSORIES

1 EA

20.14

60.42

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 16

BRAND1

ITEM12360

MANUFACT CORP

TYJGN96753

123456789123

SHIPPING SUPPLIES

150/CS

40.21

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 17

BRAND4

ITEM12361

MANUFACT CORP

YND0000017

123456789123

SUPPLIES NON FOOD AND EQUIPMENT

25/CS

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 18

BRAND4

ITEM12362

MANUFACT CORP

TP4U

123456789123

JAM JELLY NUT BUTTER

200/1 OZ

62.86

14567458

Alliance for Innovation

City of Industry

DPW

123 Main Street

New London

12345

CUST1

INV1111

4/12/22

ITEM 19

BRAND1

ITEM12363

MANUFACT CORP

3467GREN

123456789123

TOMATO PRODUCTS SHELF STABLE

25/CS

28.16

14567458

Distributor Location, the distribution center the invoice was filled out of

Customer Location, the name of the customer location correlating with the Customer Account Number

Customer Address, the address correlating with the Customer Location

Customer City, the city correlating with the Customer Location

Customer State, the state correlating with the Customer Location

Customer Zip Code, the zip code correlating with the Customer Location

Customer Account Number, the code or number the distributor uses to identify a customer account ship-to

Invoice Number, the number assigned to the invoice

Invoice Date, the date the invoice was filled

Item Description or Product Description, describes what the prouduct is

Brand, the brand of the product

Distributor Product Code (DPC) or Distributor Product Number, the code a distributor has assigned to a product

Manufacturer Name, the name of the manufacturer of the product

Manufacturer Product Code (MPC) or Manufactuer Product Number, the product number the manufacturer has assigned to the product

A Global Trade Item Number (GTIN) is a 12-digit, unique identifier for a product.

*Optional Product Category, the category the product sold is in

Pack Size, the amount of the product in each unit

The Unit of Measure the product is sold by

Quantity, how many units of the product was sold

Weight, if item sold by weight

Weight Indicator, Y/N indicating if product is sold by weight

Unit Price, price per unit sold

Extended price, unit price multipled by the quantity purchased

Sales tax

*Optional Purchase Order Number

Sheet1

$115.77
$1,043.86
$297.77
$189.04
$2,557.73
$864.61
$296.45
$97.05
$219.94
$1,011.24
$221.27
$157.24
$495.30
$2,209.78
$257.42
$556.54
$139.22

image1.jpg

File details come from the government source that posted it. Updated Dec 16, 2025.