Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Rec Center Gym Lights
Solicitation number
25-037
Issued by
Jefferson County, Weston CDP, Colorado

About this file

This is a sample billing form document issued by the City of Wheat Ridge, Colorado, for use by vendors providing services on city projects. The form is designed as an informational template to standardize invoice submissions and includes sections for recording basic service tasks with associated fees, percentage of completion, fees earned, prior billing amounts, and additional services. The document requires vendors to document the period of service, project details, and a summary of work performed with supporting reports. Billing submissions must be signed by both the vendor and the appropriate city department approver and submitted to the City of Wheat Ridge Accounts Payable department located at 7500 W. 29th Avenue, Wheat Ridge, Colorado 80033.

The sample form establishes the payment structure by calculating the amount due as the difference between total fees earned and amounts previously billed. No specific pricing terms, set-asides, incumbent information, or funding sources are detailed in this template document, as it functions solely as a standardized invoicing instrument for the city's accounts payable process. The form does not contain contract-specific financial data, budget limitations, or renewal terms, making it applicable across multiple city projects and service categories.

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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 .