Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Door Access Readers
Solicitation number
26-17
Issued by
Jefferson County, Weston CDP, Colorado

About this file

This is a sample billing form document for the City of Wheat Ridge, Colorado, designed for vendors to submit invoices for services rendered. The form provides a standardized template for tracking basic services and additional services, requiring vendors to document task descriptions, fee amounts, percentage completion, and fees earned against prior billing amounts to determine the total amount due. The form requires authorization signatures from both the vendor and the City Department approver and must be submitted to the City of Wheat Ridge Accounts Payable department located at 7500 W. 29th Avenue, Wheat Ridge, CO 80033.

The billing form contains designated sections for itemizing charges, calculating amounts earned versus previously billed amounts, and documenting additional service charges beyond the basic service agreement. This template establishes a consistent invoicing procedure for municipal vendors and includes fields for service period documentation, contact information, and approval tracking to ensure proper authorization and payment processing through the City's accounting system.

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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 .