AlaskaTelecommAttachmentJ.7SampleInvoice.doc

SOLICITATION NO. GS-10T-07-ECP-0003

ALASKA STATEWIDE

ATTACHMENT J.7

SAMPLE INVOICE

Sample Invoice General Services Administration

Alaska Statewide

Contract Number: GS10…….

Date of Invoice

GSA ACT Number (7 digits)

Billing Telephone Number (XXX) 123-4567 for Service in

Alaska, Service Tiers 1, 2 and 3

Billing Period: January 1, 2008 to January 31, 2008 Previous Balance:

$00000.00

Payments

$00000.00

Credits

$ 000.00

Current Charges 1/1/06 – 1/31/06

$12,456.78

Order Activity Total:

$ 1,000.00

Total Balance Due:

$13,456.78

Page 2 (with header information BTN, GSA ACT) Bill date

Detail of Order Activity:

Vendor Completion

GSA Customer & order # Order # Date Total SIC

076811 076811-06-000123 ABC123 1/13/06 $500.00

Add Quantity 100 to CLIN 123XYZ (206) XXX-XXXX

076095 076095-06-000124 DEF456 1/12/06 $100.00

Move 1 line CLIN 456ABC to Room 9999 (206) XXX-XXXX

076999 076999-06-000555 GHI789 1/03/06 $400.00

Install 1 CLIN 789DEF SDP 2 (206) XXX-XXXX

Page 3 (with header information BTN, GSA ACT) Bill date

ACCOUNT DETAIL

GSA Customer 076001

Worksite 0003

Telephone Number

CLIN

Quantity Monthly Rate List each 10 digit number

(includes directory listing charges)

Text of the Directory listing: US Government Blue Pages, US Department of Everything Toll Free xxx-xxx-xxxx

123 ABC Avenue, Suite 000 Local Fax (NPA) NXX-1234

Anywhere, Any State ZIP

Customer Total Monthly Recurring charges

(total of all CLINs above): $1111.11

PAGE

Attachment J.7 Sample Invoice