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Contract Firm’s Name
INVOICE
Main business office Address
| Firm’s Billing Contact Name and information |
| Summary |
| Contract # |
| Task Order # |
| THUs Purchased |
| THUs Delivered |
| Percent Complete |
| Item |
| Quantity |
| Description |
| Unit Price |
| Cost |
| 1 |
| 21 |
| FEMA 3 Bedroom Northern UFAS |
| $10,000 |
| 210,000 |
| 2 |
| 21 |
| Delivery Cost from Mfg to ND 500 miles |
| 5.00 |
| 52,500 |
| 3 |
| 16 |
| FEMA 3 Bedroom Southern Standard |
| $10,000 |
| 160,000 |
| 4 |
| 16 |
| Delivery Cost from Mfg to Selma THSS |
| 500.00 |
| 8,000 |
ALL DATA IS NOTIONAL
Signature Date
| Contract Firm’s Name |
| INVOICE |
Detailed invoice
Detailed Invoice
| Item |
| MHU Barcode |
| Bed room(s) |
| Unit Type |
| Acceptance Date |
| Description |
| Unit Price |
| Cost |
| Northern UFAS |
| 21 |
| FEMA 3 Bedroom Northern UFAS |
| $10,000 |
| 210,000 |
| 21 |
| Delivery Cost from Mfg to ND 500 miles |
| 5.00 |
| 52,500 |
| 16 |
| FEMA 3 Bedroom Southern Standard |
| $10,000 |
| 160,000 |
| 16 |
| Delivery Cost from Mfg to Selma THSS |
| 500.00 |
| 8,000 |
| _____________________________________________ | _________________________________________ | |
| Signature | | Date |