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sK * Date AddressS I hereby certify that the services listed below have been rendered, and that I have' received the check for payment in full. Check Number Purchase Order # Receipt of Payment Amount Vendor Name Service Provided Vendor Signature3 Please return this signed form to Accounting & Fees
Date Provided Phone Quantity Total Service Description Service Date Invoice # PO # Invoice Date Amount of Invoice Modeling for Art 1100 Modeling for Art 1200
Cost per Unit* I am an employee of the State of Minnesota= *Per MN Statute 16A.124 - Payments will be made to the vendorR within 30 days following the receipt of the invoice for the completed service(s). NO YESo I hereby certify that the services listed above have been rendered, this is my only invoice for these services,= it is correct and just, and that no part of it has been paid.b The above services have been completed as described and payment is approved for services rendered. Authorized Signature
NHCC USE ONLY
Mary Smith 123 Main Street St Paul, MN 55747 X
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( ` - used to pay a vendor providing service to NHCC (if vendor does not have their own invoice) Cindy Ri S u m m a r y I n f o r m a t i o n (
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x Vendor Invoice Example Invoice Receipt Worksheets | ( T \ p ContentType ReportOwner Document
F Microsoft Excel 2003 Worksheet Biff8 Excel.Sheet.8 9q