Attachment_12_Sample_Invoice__6_pages.pdf

Attachment (12): Sample Invoice

Company Name Street Address City ST ZIP Code Phone (000) 000-0000 Fax (000) 000-000

INVOICE

INVOICE #0000

DATE: MONTH DAY, YEAR

FOR:

Contract: 0000000000 Title: YDP O&M Support Services Month Day, Year to Month Day, Year

TO:

IPP VIA https:://www.ipp.gov In accordance with FAR 32.905(b) and contract Section G:

Electronic Invoicing and Payment Requirements-Invoice Processing Platform (IPP) APR 2013

DESCRIPTION AMOUNT

Base Year, 2019

CLIN XXXX: Accounting and Appropriation Data: FYXR0000X0.RX00000XXXXX0000 $000,000.00

Routine O&M Services of the Yuma Desalting Plant, Plus Research, Plus YDP Maintenance, Plus YDP Operations – SCENARIO X

CLIN XXXX: Accounting and Appropriation Data: FYXR0000X0.RX00000XXXXX0000 $000,000.00

Variable IDIQ Hours

CLIN XXXX: Accounting and Appropriation Data: FYXR0000X0.RX00000XXXXX0000 $000,000.00

Materials and Small Chemical Purchases

TOTAL $000,000.00

Attachment (12): Sample Invoice

Contract Line Item Number (CLIN) XXXX – Routine O&M Services of the Yuma Desalting Plant, plus Research, plus YDP Maintenance, plus YDP Operations – SCENARIO X from Contract Award document is for fixed labor rates, labor hours and time and materials for the operation and maintenance of the Yuma Desalting Plant, Yuma Area Office.

CLIN XXXX – Variable IDIQ Hours from Contract Award document is for any billable variable IDIQ (Indefinite Labor-Indefinite Quantity) labor hours for additional work required over the base hours described in CLIN XXXX to bring the YDP to a higher state of readiness. Supporting documentation shall be provided and can be in the form of overtime requests, task orders or modifications.

CLIN XXXX – Materials and Small Chemical Purchases from Contract Award document is for reimbursement of any material costs related to the operation and maintenance of the Yuma Desalting Plant, Yuma Area Office.

Supporting documentation shall be provided and can be in the form of receipts, invoices or bills received from vendors, suppliers, or retailers.

REQUESTOR WORK ORDER NUMBER:

Company Name:

Estimated Tax

PRIORITY:

Address:

City, State, Zip:

Phone:

E-Mail:

Website:

Fax:

RECOMMENDED SOURCE:

Contact:

DELIVER TO: Bureau of Reclamation, Yuma Area Office 7301 Calle Agua Salada, Yuma AZ 85364

Yes NoSDS Required:

ITEM

PART NO. DESCRIPTIONQTY

UNIT PRICE TOTAL

Subtotal Pg 2 ofPage

Sole Source Required: Yes

Request for Supplies/Services

If Yes, attach approved SDS or SDS No.

CATEGORY:

YDP, PS1, Research, CRADA

DATE:

Requester Signature:

FOR PURCHASE:

MODEL

COR - Bureau of Reclamation Date

APPROVAL

REQUIRED

X

REQUIRED

Contract Manager Date

FOR QUOTATION:

No If Yes, attach justification.

DDN:DATE NEEDED:

EXTENSION:

Estimated Total Cost

Estimated Freight

Subtotal

PR #

PR Justification: