Attachment J.10 Clinical East Monthly Invoice Submission Template.xlsx
XLSX spreadsheet 40 KB Posted
- Solicitation number
- PSCFOH-ClinicalEastStaffing-Solicitation75P00125R00012-R
About this file
Attachment J.10 is a monthly invoice submission template for a Federal Occupational Health (FOH) Clinical East Staffing contract. The template is designed for invoicing labor and travel expenses, with specific columns for site code, job title, employee name, hours worked, rates, and total amounts due. The template includes detailed sections for clinical staff such as Nurse Coordinators, Staff Nurses/RNs, and Medical Administrative Support Staff, with employees listed from various locations including MD, VA, and DC.
The related federal contract opportunity (Solicitation Number PSCFOH-ClinicalEastStaffing-Solicitation75P00125R00012-R) is a total set-aside for 8(a) small business concerns, issued by the Department of Health and Human Services. The solicitation seeks professional medical staffing, occupational health professionals, and ancillary staff for the Clinical Eastern Region. All questions must be submitted via email to the Contract Specialist Angelina Mulenga, with submission instructions detailed in Sections L and M of the solicitation document.
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Text version
INVOICE
Clinical East Monthly Invoice Submission Template
ATTACHMENT J.10
| INVOICE |
| PLEASE MAIL YOUR REMITTANCE TO: |
| Contractor's Name, TAX ID Number, Duns Number | |
| Contractor's Address | |
| Contractor's Phone Number | |
| Invoice Date | |
| Invoice # |
| CONTRACT # |
| FOR THE PERIOD OF : |
LABOR
CAN Site Code State Job Title Cost Center Employee Name ConCat Monthly Hrs Worked Rate Total Due Vendor Comments FOH Comments
CLINICAL TOTAL:
TRAVEL
CAN Site Code Description CC Employee Name Date(s) of Travel Total Due Vendor Comments FOH Comments
TRAVEL TOTAL:
TOTAL AMOUNT DUE:
Grand Total
| MD | ||
| Z0Y | Nurse Coordinator I | Cody, Sharon |
| A7F | Nurse Coordinator I | Gaines, Carol |
| A7F | Staff Nurse/RN | Wuerstlin, Rebecca |
| VA | ||
| Z3U | Nurse Coordinator I | Burns, Andrea |
| Occ Health Orientation Hours | ||
| DC | ||
| A54 | Staff Nurse/RN | Harry, Beverly |
| A7E | Nurse Coordinator I | Rostami, Christine |
| Z0A | Med Admin Support Staff | Law, Schae |
| Z0G | Area Nurse Manager | Sharon, Cynthia |
| MD | ||
| A7F | Staff Nurse/RN | Johnson, Nicole |
| Z8A | Staff Nurse/RN | Johnson, Nicole |
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File details come from the government source that posted it. Updated .