ESBD_563015_1790361758609_Attachment 2 - Billing Statement.xlsx

This is a billing statement template for the Texas Workforce Commission (TWC), specifically designed for use by Impartial Hearing Officers contracted under the Vocational Rehabilitation program. The document serves as a standardized invoice form that contractors submit to the TWC General Counsel's office, directed to Attn: Melissa Collins at the Austin headquarters. The billing statement includes fields for contractor identification information (name, address, contact details), contract and purchase order numbers, and a docket number formatted as VR (year)-XX for tracking purposes. The form is structured to itemize billable activities and expenses with corresponding time charges and costs, culminating in subtotals and a total services rendered amount.

The template contains placeholder fields with default values of $0.00 for both subtotals and total services rendered, indicating this is a blank form awaiting completion by individual contractors. Billing dates are formatted as MM/DD/20YY for monthly invoice submission. The document does not specify minimum or maximum billing amounts, hourly rates, payment terms, or frequency of billing cycles, suggesting these terms are established elsewhere in the underlying contract agreement. This billing statement form is a standard administrative document for managing contractor compensation and expense reimbursement under the TWC's Vocational Rehabilitation Impartial Hearing Officer contract.