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<br />Mn/DOT Contract No. 91083 <br />Exhibit B, Invoice <br /> <br />INVOICE NO. <br /> <br />Original To: <br /> <br />Minnesota Department of Transportation <br />Consultant Services Section, Mail Stop 680 <br />395 John Ireland Boulevard, St. Paul, Minnesota 55155 <br /> <br />Estimated Completion: % <br />(from Column 6 Progress Report) <br /> <br />Copy: <br /> <br />Mark Lindeberg, State's Project Manager <br /> <br />Period Ending: <br />Invoice Date: <br /> <br />C;opy: <br /> <br />Jennifer F~ricy, State's Authorized ~epresentative <br /> <br />Re: <br /> <br />MnlDOT Contract No. 91083 <br />SP Number: 0202-90 <br />p' D TH lOP r . <br /> <br />Contract Expiration Date: May 1, 2009. <br />THNumber: 10 <br />D . <br /> <br />rOlect escnptlOn: re Immary eSlgn <br /> Total Total Amount Billed <br /> Contract Billing Previously This <br /> Amount to Date Billed Invoice <br />1. Lumpsum $62,500.00 <br />Net Earninl?:s Totals: $62,500.00 <br /> Total Amount Due This Invoice: <br /> <br />Contractor: Complete this table when <br />submittin!! an Invoice for pa ment <br />Activity Total Amount Billed This <br />Code Billing to Previously Invoice <br /> Date Billed <br />1129 <br />Total * <br /> <br />I certify that the above statement is correct and <br />payment has not been received. <br /> <br />Signature: <br /> <br />Print Name: <br /> <br />*Must Match Net Earnings Totals Above <br /> <br />Title: <br /> <br />For Consultant Services Use Only <br /> <br />Billing Address: Anoka County Highway Dept. <br />1440 Bunker Lake Boulevard <br />Andover, MN 55304 <br /> <br />Telephone: <br /> <br />. (763) 862-4230 <br /> <br />Approved for Payment: <br /> <br />Date: <br /> <br />s <br /> <br />Page 1 of 1 <br /> <br />-395- <br /> <br />(CSSReviewed 5/3/2007) <br />