Attachement B_Sample Invoice.pdf

Attachment B is a sample invoice template designed for use in state and local contract administration. The document provides a standardized format for contractors to submit billing documentation to agencies for services rendered at specific project sites identified by site number, site name, county, and city.

The invoice template accommodates four primary billing categories: mobilization charges calculated on a per-mile basis, per-ton removal charges based on tonnage transported, per-ton-mile charges for cleanup-to-processor transport services, and specialized equipment charges requiring prior agency approval. Each category includes fields for contract rates, quantities, and total charges, with subtotals feeding into an aggregate total. The template structure allows flexibility for varying service types while maintaining standardized documentation across invoicing cycles. All sample line items display $0.00 placeholder values, indicating this document serves as a blank form for completion by contractors during actual billing periods.