Contractor Invoice Template (Page 3 of 6) in pdf

Contractor Invoice Template Page 3

Exhibit A-1

MAIL ALL INVOICES TO: RIT – ATTN. ACCOUNTS PAYABLE

7 Lomb Memorial Drive, Rochester, NY 14623

CONTRACTOR INVOICE

RIT PO # ____________

INVOICE NO. ____________

RIT PROJECT # __________

PERIOD FROM ___________

ORIGINAL PO AMOUNT

CHANGE ORDERS

TOTAL AUTHORIZED (Line 1 + 2)

COMPLETED TO DATE

PREVIOUSLY INVOICED

AMOUNT OF THIS INVOICE (Line 4 - 5)

_____

Partial Billing

_____

Final Billing

BALANCE REMAINING (Line 3 - 4)

SPECIAL INSTRUCTIONS FOR T & M INVOICES:

Line 1 – Insert the words “not to exceed” and the dollar amount authorized on the T&M Purchase

Order.

Line 2 – If actual T&M performed exceeds the Line 1 amount, call RIT Project Manager and

arrange for a change order PRIOR to submitting an invoice.

Line 6 – Attach detailed back-up for labor and material. Mark up limited to 10%.

NOTE: A Waiver/Release of Lien form from each Contractor and Subcontractor must

accompany this invoice.

C:Documents and Settingsjmr4966DesktopLien Releases.doc

Rev. 02/21/07

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Contractor Invoice Template Page 3