Invoice Consultant - Free Download
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INVOICE AND CERTIFICATION FOR CONSULTING SERVICES
Rev. 2-27-12
Date: ___________________
Consultant Contract No. _______________ Hourly Billing Rate: $_________
CLIN 1: _________________ CLIN 2: _____________
Billing Period of Performance: ___________________ (e.g. January 1, 2012 through January 31, 2012)
I hereby request payment for the following CLIN(s)** pursuant to my Contract:
CLIN 1 Consultant services of _______ hour(s) CLIN 1 Labor sub-total $______________
CLIN 2 Consultant services of _______ hour(s) CLIN 2 Labor sub-total $______________
** Add additional CLINs on separate sheet if necessary.
Sub-Total Labor all CLINs $ ______________________
Expenses incurred for travel and subsistence in connection with the consulting services set forth
above. Details are set forth on the Travel Expense Statement attached hereto. (Attach copies
of receipts for transportation, car rentals, hotels, per the Contract terms to the Travel Expense
Statement.)
CLIN 1 Travel & ODC’s $
CLIN 2 Travel & ODC’s $
Sub-Total Travel & ODC’s all CLINs $_________________
Sub-Total CLIN 1 costs: $_____
Sub-Total CLIN 2 costs: $______
Total Invoice Amount $__________________
I certify that this invoice and attached activity report represents a full and complete claim for
consulting services performed during the billing period of performance indicated above and
expenses claimed in connection therewith under the specified Contract; that payment therefore
has not been made and will not be accepted from any other source; and that to the best of my
knowledge and belief no salary or other expenses have been or will be charged to any other
Government contract or Government activity while performing said consulting services.
Consultant’s Signature:
Consultant’s Name (please print):
Mail Remittance to (address):
Note: APL CONSULTANT ACTIVITY REPORT must be completed and attached in order
for this invoice to be paid.
FOR APL USE ONLY
APL Technical Representative Payment Authorization Received: _______________
APL Contract Representative Payment Authorization Signature: ____________________ Date _____________
