Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Anderson Pool Replacement Owner's Representative
Solicitation number
26-42
Issued by
Jefferson County, Colorado

About this file

This is a sample billing form document provided by the City of Wheat Ridge, Colorado, in connection with the Anderson Pool Replacement Owner's Representative contract opportunity. The form is designed for vendors to submit invoices for services rendered during specified periods. It includes sections for documenting basic service tasks with associated fees and percentage completion metrics, allowing vendors to calculate amounts earned, reconcile against prior billings, and identify current amounts due. The form also accommodates additional services beyond the basic scope and requires approval signatures from both the vendor and the responsible city department before submission to the City of Wheat Ridge's Accounts Payable office.

The billing form establishes the submission process and administrative requirements for the Anderson Pool Replacement project, which involves managing the replacement of Anderson Pool located at Anderson Park (4355 Field St., Wheat Ridge, CO 80033) through design, demolition, and construction phases. Invoices must be submitted to the City of Wheat Ridge Accounts Payable department at 7500 W. 29th Avenue, Wheat Ridge, CO 80033. The Owner's Representative firm selected to manage this project is anticipated to be chosen in August 2026, and the billing form will serve as the standard payment documentation mechanism throughout the project's duration.

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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 .