Sample_Billing_Form_-_Informational_Only.pdf

PDF 135 KB Posted

Attached to
Sidewalk Gap Construction
Solicitation number
26-44
Issued by
Jefferson County, Weston CDP, Colorado

About this file

This is a sample billing form provided by the City of Wheat Ridge, Colorado for informational purposes related to the Sidewalk Gap Construction contract opportunity. The form is designed to facilitate vendor billing and payment processing for services rendered under the contract. The billing form includes sections for documenting basic service tasks, fees, percentage of work completion, fees earned, and prior billing amounts. Additional services can be itemized separately on the form. The document requires vendor signatures, printed names, titles, and approval signatures from the appropriate City department representatives before submission.

Billing submissions under this form should be directed to the Accounts Payable department at the City of Wheat Ridge, located at 7500 W. 29th Avenue, Wheat Ridge, Colorado 80033. The form requires specification of the project name and number, the City contact name or department, and the period of service covered by the billing period. The total amount due is calculated by subtracting amounts previously billed from the total fees earned for both basic services and any additional services rendered. This standardized billing form ensures consistent documentation and processing of contractor invoices for the Sidewalk Gap Improvements Program.

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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 .