Sample_Billing_Form_-_Informational_Only.pdf
PDF 135 KB Posted
- Solicitation number
- 25-41
- Issued by
- Jefferson County, Weston CDP, Colorado
About this file
This document is a sample billing form for the City of Wheat Ridge, located in Colorado. The form is designed for vendors to submit invoices for services rendered, with spaces to detail basic and additional services, including task descriptions, fee amounts, percentage of completion, and billing information. The form provides a structured template for contractors to document their work and request payment from the city's Accounts Payable department.
The billing form allows for detailed financial reporting, with sections for calculating total fees earned, previously billed amounts, and the current amount due. Vendors are required to provide their signature, printed name, and title, and the form includes a section for city department approval. The document is to be submitted to the Accounts Payable department at 7500 W. 29th Avenue, Wheat Ridge, CO 80033, with space for specifying the project name, contact person, and period of service.
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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 .