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 developed by the City of Wheat Ridge, Colorado, for use in processing vendor invoices and service payments. The form is designed to track and document charges for services rendered, allowing vendors to submit itemized billing for both basic services and additional services provided to the City. The form requires vendors to specify the project name and number, service period, task descriptions, fee amounts, percentage of completion, and fees earned. Submission instructions direct vendors to send completed forms to the City of Wheat Ridge Accounts Payable Department located at 7500 W. 29th Avenue, Wheat Ridge, Colorado 80033.

The billing form requires calculation and documentation of amounts due based on fees earned minus prior billing, with separate line items for basic services and additional services. The form mandates vendor signature, printed name, and title, along with approval signature and date from the appropriate City Department approver, ensuring proper authorization and documentation of all charges before payment processing. This standardized format facilitates consistent tracking of service costs and enables clear communication between vendors and the City regarding compensation for contracted work.

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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 .