Invoicing Request Form

Site Directors and Executive Directors: Please use the following form to request that a customer be invoiced for work completed on an existing revenue agreement.

Project Director/Site

The following information is required for all invoices.

Customer Organization Name

Invoice Amount $

Invoice period (e.g. January 2025, April-July 2024)

The following information is optional, but helpful.

Contract Number (if known)

Total Contract Amount $

Approved Hourly Rate $ /hr

Hourly rate is determined by your project's approved rate agreement. Charging an amount other than the approved rate for the same type of services is not permitted. If you have any questions regarding how to charge appropriately, please contact Jeremy Till.

Number of hours to be invoiced

Is this an interim or final invoice?

Interim

Final

Other Information