EXHIBIT “B-1”
MONTHLY INVOICE COVER SHEET
Date
Invoice No._____________
AE Project No._____________
CSA/ASA No._____________
To:
UMHHC, Facilities Planning & Development
2101 Commonwealth, Suite B, SPC 5759
Ann Arbor, Michigan 48105
Attn: Denise Seibert, Capital Budgets
From:
(Design professional name and address)
_______________________________
_______________________________
_______________________________
_______________________________
(Progress or Final) billing for services rendered for period from (Month/Day/Year)
(Month/Day/Year) in connection with:
RTN No. ____________________________________
Project Title ____________________________________
Contract Lump Sum Amounts
Contract Lump Sum
Total Invoiced to Date
Current Invoice Amount
Fees
$
$
$
Reimbursables
$
$
$
1.
A breakdown of all reimbursable expenses with appropriate support documentation/actual receipt must be attached.
2.
A copy of the appropriate CSA/ASA signature page must be attached.
Document1
Total
$
$
$
to