Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Towing & Impound Services
Solicitation number
26-6
Issued by
Jefferson County, Weston CDP, Colorado

About this file

This is a sample billing form document provided by the City of Wheat Ridge, Colorado, for use in connection with the Towing & Impound Services contract opportunity. The form serves as an informational template for contractors to submit invoices for services rendered to the city. The document outlines the structure for billing submissions, requiring vendors to document the period of service, identify the specific project, and reference the responsible city contact or department.

The billing form is structured to accommodate both basic service fees and additional services charges. Contractors are required to indicate the task description, fee amount, percentage of work completed, and fee earned for basic services, then deduct any prior billing amounts to calculate the total amount due. The form requires vendor signature with printed name and title, as well as approval signature from the appropriate city department approver before submission. Completed forms should be submitted to the Accounts Payable department at the City of Wheat Ridge's address located at 7500 W. 29th Avenue, Wheat Ridge, CO 80033. The form provides no specific information regarding pricing structures, contract terms, or payment schedules, serving instead as a procedural template for invoice processing and authorization.

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Text version

SAMPLE BILLING FORM - For Example Only

Date:

City Project Name and Number:

City Contact Name or Department:

Period of Service: through Summary below (see attached reports for further details)

BASIC SERVICE

Task: Fee Amount: % Complete: Fee Earned: Prior Billing:

TOTAL:

Fee earned: $

Less amount previously billed: $

Amount due: $

ADDITIONAL SERVICES:

Amount due: $

TOTAL AMOUNT DUE: $

Vendor’s signature: Date:

Printed name: Title:

City Department approval (signature of approver):

Title: Date:

SUBMIT TO:

ACCOUNTS PAYABLE

CITY OF WHEAT RIDGE

7500 W. 29th Avenue Wheat Ridge, CO 80033

File details come from the government source that posted it. Updated .