Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Contracted, Part-time Municipal Prosecutor
Solicitation number
26-001
Issued by
Jefferson County, Weston CDP, Colorado

About this file

This is a sample billing form designed for use by the City of Wheat Ridge, Colorado, and other municipal entities to document service payments and track billing cycles. The form is intended to be completed on a per-project basis and submitted to the respective city's accounts payable department. The document provides a standardized template for vendors to report fees earned, deductions for prior billings, and amounts due for both basic services and additional services rendered during specified periods of service.

The form requires vendors to itemize basic service tasks with associated fee amounts and percentage completion, calculate total fees earned, deduct any amounts previously billed, and document the resulting amount due. Additional services may be listed separately to distinguish them from basic contracted work. The form includes signature lines for vendor authorization and city department approval, with the completed document directed to the City of Wheat Ridge's Accounts Payable office located at 7500 W. 29th Avenue, Wheat Ridge, Colorado 80033. This template establishes a consistent billing methodology across municipal projects and ensures proper documentation and approval before payment processing.

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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 .