Common use of SAMPLE INVOICE TEMPLATE Clause in Contracts

SAMPLE INVOICE TEMPLATE. Senior Non-Emergency Medical Transportation Program A. Non-Ambulatory Transportation ServicesB. Non-Ambulatory Transportation ServicesC. Transportation Services Curb-to-CurbD. Transportation Services Door-to-Door Curb-to-Curb Door-to-Door 0 0.00 N/A Less Project Income Balance: TOTAL REIMBURSEMENT: Month Subtotal PreviousTo Date Contract To Date Client Collections Fundraising Donations In-Kind Contributions Total $0.00 $0.00 $0.00 Unreimbursed mileage subsidized with contributed funding: MonthSubtotal Previous To Date Contract To Date Rate Mileage Total 0.0 $0.00 $0.00 $0.00 Contributed funding for unreimbursed mileage remaining balance = $0.00 FOR COUNTY USE ONLY: ACCOUNTING CODE Reimbursable Advance/Reversal FUND DEPT BUDGET CONTROL UNIT OBJ REV BSA SUB-OBJ SUB-REV SUB-BSA DEPT OBJ DEPT REV DEPT BSA JOB NUMBER AMOUNT Performance Line No. July Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun FY To Date

SAMPLE INVOICE TEMPLATE. Senior Non-Emergency Medical Transportation Program A. Non-Ambulatory Transportation ServicesB. Non-Ambulatory Transportation ServicesC. Transportation Services Curb-to-CurbD. Transportation Services Door-to-Door Curb-to-Curb Door-to-Door 0 0.00 N/A Less Project Income Balance: TOTAL REIMBURSEMENT: Month Subtotal MonthSubtotal PreviousTo Date Contract To Date Client Collections Fundraising Donations In-Kind Contributions Total $0.00 $0.00 $0.00 Unreimbursed mileage subsidized with contributed funding: MonthSubtotal Previous To PreviousTo Date Contract To Date Rate Mileage Total 0.0 $0.00 $0.00 $0.00 Contributed funding for unreimbursed mileage remaining balance = $0.00 FOR COUNTY USE ONLY: ACCOUNTING CODE Reimbursable Advance/Reversal FUND DEPT BUDGET CONTROL UNIT OBJ REV BSA SUB-OBJ SUB-REV SUB-BSA DEPT OBJ DEPT REV DEPT BSA JOB NUMBER AMOUNT Performance Line No. July Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun FY To Date