Personal Service Contract Invoice Form Page 2
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27. Date of most recent invoice submitted prior to this invoice:_________________
8. How often is the contractor required to submit invoices under the terms of the personal
service contract:
9. Provide a description of the matter covered by this invoice:
10. Provide a full description of each service provided, including the date each service was
performed, the name and title of each individual who worked on the matter, and the time
the individual spent on the matter:
11. Provide the hourly rate for each individual working on the matter and the total charge
for that individual for each matter involved:
12. Provide the subject matter and recipient of any correspondence:
13. Provide a full description of any work product produced, designating the way in which
the work product is associated with the matter being invoiced. (Attorneys Billing for Legal
Services: If you contend that any information is subject to privilege, please identify the
privileged item, and provide sufficient information to evaluate the claim of privilege):
14. Provide an itemized list of all disbursements to be reimbursed by the state for each
matter invoiced and the total charge for that matter:
SIGNATURES:
Contractor:___________________________
Date:_______________
Title:_________________________________
Contracting Body
Approved by:_________________________
Date:_______________
Title:________________________________
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Parent category: Business