CTR072042_Exhibit_C_Invoice.docx
DOCX document 140 KB Posted
- Attached to
- Master Agreement AZ|CTR072042
- Contract number
- CTR072042
- Issued by
- Arizona
About this file
This document is an invoice template for a contract between an unnamed contractor and the Arizona Department of Economic Security (DES). The invoice is designed for monthly billing purposes, with specific sections for the contractor's contact information and a billing address for the DES Contracts Department located in Phoenix, Arizona.
The invoice template includes line items for monthly personnel, travel, operational, and indirect costs. The operational cost is set at $8,096.08 per month, while other line items are priced at $1.00. The document provides space for tracking budget ceiling, year-to-date invoiced amounts, and remaining balance. The invoice requires an authorized signature certifying the accuracy of services delivered under the contract, but specific contract details such as the full contract number, term, and precise scope of services are not fully detailed in this document.
View the file
Other files
Show all 24
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
[Contractor]
[Address]
[City, State, Zip Code]
[Telephone]
Contract Number:
Contract Term:
Purchase Order Number:
BILL TO:
Arizona Dept. of Economic Security Contracts Department 1789 W. Jefferson, 1st Floor MD 85C1 Phoenix, AZ 85007 dcccontracts@azdes.gov
Service Month: _______________________
| DESCRIPTION |
| QTY |
| UNIT PRICE |
| TOTAL |
One (1) Month of Personnel Cost
| $1.00 |
| $ |
One (1) Month of Travel Cost
| $1.00 |
| $ |
| One (1) Month of Operational Cost |
| 1 |
| $8096.08 |
| $ |
One (1) Month of Indirect Cost
| $1.00 |
| $ |
| Balance Due: |
| $ |
Remarks / Payment Instructions:
Budget Ceiling:
Year to Date Invoiced:
Balance Remaining:
I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE STATEMENT OF SERVICES DELIVERED UNDER THIS CONTRACT.
Authorized Signature: _________________________________________________________ Signature Date
File details come from the government source that posted it. Updated .