Attachment Monthly Invoice Sample.pdf

This is a Monthly Invoice Sample document provided by the Maryland Department of Juvenile Services (DJS) for dental services at the Baltimore City Juvenile Justice Center (BCJJC). The sample invoice serves as a template for billing purposes and outlines the format and information required when submitting invoices for reimbursement of dental services rendered to male youth detainees aged twelve to twenty years old at the facility. The document establishes the invoicing structure and documentation requirements that the successful bidder must follow when billing the Department for services performed on-site in the BCJJC dental suite.

The invoice template includes designated fields for contractor identification, service dates, descriptions of services provided, quantities of procedures or visits, unit rates, and total amounts due. The document specifies the information elements necessary for proper invoice processing and payment authorization by DJS, ensuring standardized billing practices and facilitating accurate tracking of dental services provided to the youth population. This sample invoice format must be adhered to by the awarded vendor to ensure compliance with Department payment procedures and contract requirements.