Sample Subcontract Invoice

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SAMPLE SUBCONTRACT INVOICE
Your
organization’s
logo/letterhead.
Invoice Date:
TO:
Brenda Duggins
INVOICE NUMBER
Southern Risk Management Education Center
2301 S. University Ave.
(MUST BE UNIQUE)
Little Rock, AR 72204
SUBAWARD NO: 21663-_____
REFERENCE:
Project Title and Project Director
BILLING PERIOD:
(EX.) 07/01/2013-07/31/2013 (Must fall within your subcontract period)
Budget
Current
Cumulative
Description
Amount
Amount
Amount
(Expenses being claimed should be via line item as allocated in
your approved budget. The cumulative amount billed should not
exceed the budgeted amount in a category.)
Salaries & Wages
Fringe Benefits
Travel
Services
Materials & Supplies
Equipment
Facilities & Admin Costs
Other Direct Costs (Itemized/Described Below)
Total
Total
Total
Certification Statement
I certify that all the expenditures reported are for appropriate
purposes and in accordance with the agreement set forth in the
applications and award documents.
_______________________________________________
Signature
Please contact _________________ at 555-555-5555 or
__________@__________ if you have any questions regarding this
invoice.
Remit Payment to:
Vendor Name and Complete
Mailing Address

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