CP 0197 Professional Service Invoice Form
CP 0197 Professional Service Invoice Form
CP 0197 Professional Service Invoice Form
BILLING PERIOD:
From: BEG DATE To: END DATE
Remit To:
Company Name: COMPANY NAME Date: DATE
Address: ADDRESS Contract No.: CONTRACT NO
City: CITY Task Order No: TASK ORDER
State, Zip Code: STATE ZIP CODE College: DISTRICT
Invoice No: INVOICE NO
Billing Period:
Note: Project Labor Log(s) and all supporting documentation needs to be attached when applicable
Date Category/Classification of Work Employee / Inspector Name Unit Rate Number of Units Total
$ - 0.00 $ -
$ - 0.00 $ -
$ - 0.00 $ -
$ - 0.00 $ -
$ - 0.00 $ -
Reimbursables:
Category of Expenses Amount Contract Reimbursables:
[list item] $ - Amount Due This Period $ -
[list item] $ - Prior Billed to Date $ -
[list item] $ - Total Billed to Date: $ -
BILLING PERIOD:
BEG DATE To: END DATE
TOTAL AUTHORIZED BUDGET:
Professional Services: $ -
Contract
Reimbursables: $ -
Authorized Budget $ -
PROFESSIONAL SERVICE DETAIL:
To be used by all hourly-unit based contracts/task orders with proposal
Authorized Budget
% (matches Invoiced Previous Amount Due This Budget
Category/Classification of Work Complete proposal/TO) To Date Invoice Amt Period Remaining
#DIV/0! $ - $ - $ - $ -
#DIV/0! $ - $ - $ - $ -
#DIV/0! $ - $ - $ - $ -
#DIV/0! $ - $ - $ - $ - $ -
TOTALS $ - $ - $ - $ - $ -
Contract Hourly: $ -
Amount Due This Period $ -
Prior Billed to Date $ -
Total Billed to Date: $ -
Remaining $ -
Reimbursables:
Amount
Category of Expenses Contract Reimbursables:
[list item] $ - Amount Due This Period $ -
[list item] $ - Previous Amount: $ -
[list item] $ - Total Billed to Date: $ -
[list item] $ - Remaining $ -
[list item] $ -
[list item] $ -
[list item] $ -
[list item] $ -
Billing Period:
From: BEG DATE To: END DATE
In accordance with the Project Agreement between The Architect/Engineer and The Los Angeles Community College District Contract No.1015,
Task 01EAE, Monthly Payments may be paid upon receipt of evidence of services rendered with Architect/Engineer’s monthly statement, and with
the District’s approval. Submittal of a monthly progress report, certified by the Architect/Engineer, shall detail accomplishments in the past month,
work anticipated in the coming month and outstanding issues shall constitute evidence of services rendered.
The information provided in this progress report has been verified by the Principal Architect/Engineer for this project.
Note:
In order to comply within the terms and conditions of the Contract Agreement, attached are the following support documents:
a) Monthly Progress Report certified by the Architect for the corresponding billing period
b) If applicable, photocopy of all reimbursable items
"I certify under penalty of perjury under the law of there State of California that the above invoice and accompanying documentation are true and
correct according to the terms of the contract and that payment has not been previously requested or received."
\
Print Name
TODAY'S DATE
Principal Architect Date